You’ve given everything away, I know where the poison is

Dear Violet,

Interesting take you have on ACA and the Court-to-end-all-courts. But I’m not sure I follow you on Justice Kennedy. I don’t mean that I disagree, necessarily, but maybe I’m a little dim and am not quite following what you mean. And if Roberts is also kind of a wild card, then I think the prospects for overturning ACA are pretty slim – after all, Ginsburg, Breyer, Sotomayor & (Kagan) aren’t really up in the air anymore than the Snidely Whiplashes on the right side of the see-saw. But you know better than I do.

What I can contribute, however, is a bit of economics conjecture (NOT AN ECONOMIST exactly) that might speak to Kennedy and the health care execs. My feeling is that health care execs have not been betting on repeal or… overturnal? (ew, seriously, what’s the word I’m looking for here?) Or at least they already probably sunk a lot of capital into the administrative adjustments* that the new law requires before they realized the lunatic fringe was gonna try to litigate it, so I suspect that they might not even really have a dog in this fight.

But that’s all just stuff I kinda made up just now. I mean, you’re probably gonna ask to see some sort of evidence of that and… I’m gonna politely decline, for now at least. I mean, I can try to track down some data, but there’s only so many hours in a day and i have MUCH MUCH LESS IMPORTANT things to do, thanks.

BUT ALSO we can think about how those health care execs might be invested in the outcome, they sure did spend a lot of time bargaining with the Obama administration to get a law in place that would still allow them to profit, just not obscenely so. My thinking is that if they game out the potential outcomes they may be significantly more interested in keeping the ACA in place that seeing the Supremes strike it down. To wit: if it’s ruled unconstitutional, then the broader health care debate becomes pretty starkly defined, with the old system (which clearly wasn’t working for, yknow… people) on one hand and government-run health insurance (at least) on the other. In this case, if the health care reformers win the debate again at any point in the future, it’s a whole lot worse outcome for profits in the health care biz. Of course, that’s a mighty big if – it’s not hard to imagine progressive activists/politicians/old hippies being super-demoralized in the wake of an adverse decision on this. So I guess the position of health care execs depends in some part on what they perceive to be the eventual outcome of the political debate (and yeah, they could adapt under the old system to make health care cheap and affordable, but… come on GET REAL). Anyway: expected utilty FTW.


*Adminstrative complexity: this is exactly my problem with Rosenberg’s predictions vis-a-vis gay marriage! You and I are thinking very much alike on that… I think. This is kind of how I see it as a factor in the health care litigation as well, I guess.

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