Nobody Knows Nuthin

There hasn't been this much nail-biting and speculation since the nation awaited the series finale of The Sopranos. And when that last episode ended, not with a bang but with a quick whimpering fade to black, the reaction was a mixture of "huh?" to "cop-out!" to "this was the most meaningful and epochal moment in the history of mafia dramedy."

Same for Thursday's much-ballyhooed Supreme Court ruling on the Affordable Care Act. There are as many theories on the outcome as there are pundits with too much time on their hands, so I won't add to the arcane clutter. Possible endings are all over the map. I read this morning that the jurists may even punt on the issue until right before Election Day, following that old Washington tradition of can-kicking important issues into oblivion, as well as the gimmick of the season-ending summer cliffhanger.

I imagine this would piss off the VIPs who are sticking around the swamp just to be the first to pontificate on this momentous decision instead of raising campaign cash, serving their constituents or going on their bi-monthly vacations. Wouldn't it be something if it turned out the Supremes were just a bunch of Bada-Bing teases, that they had been playing us all along with their come-hithers on health care? 

If you are a suspense junkie, do tune in to the ScotusBlog this Thursday around 10 a.m. for the final (maybe) episode. I'm embarrassed to admit I succumbed yesterday, finding myself hooked on their live clicks. It was a real tease, all right. I could just envision the politburo dancers in their black robes, casting off one decision at a time to a ravening audience of thousands. First, Arizona immigration law, next came sentencing rules for murderous youth, and in between there was that contemptuous bump and grind affirming Citizens United. And no health care! Not one little hint! Oh, the agony.

Of course, lost in the hoopla is the fact that these decisions affect real people. Hispanics will continue to be subjected to the fascist "papers please" law in Arizona, until the Supremes decide to think it over some other time. Corporations will continue to steal our democracy and not even have to tell us who they are or where they come from.

Same with health care. As much as I dislike the Affordable Care Act, I will not rejoice if it is struck down. For one thing, the insurance leeches would be absolved from refunding billions of dollars this summer in overpaid premiums that were not spent directly on patient care. For another thing, there are some people who are already benefiting from the law, such as children with pre-existing conditions. Would they be cut off from chemo without a second thought by the for-profit health insurance mafia?

The only thing we can be sure of come Thursday is the cacophany of the chattering class and the unctuous spin of the politicians. Here's what Michael Shear of the New York Times is forecasting:

But the momentary chaos could be downright dangerous for political candidates who move too quickly to embrace or condemn the court’s actions. A stray statement made before all the facts are understood could easily come back to haunt a political candidate.

In the White House race, Mitt Romney and President Obama are both preparing for any eventuality.

Mr. Romney’s top advisers have been working with Republicans on Capitol Hill to coordinate the health care message, according to senior aides. Various scenarios have been sketched out and statements prepared.

Aides say they believe Mr. Romney can benefit politically no matter what the court decides.

At the White House, Mr. Obama’s lawyers and political advisers are said to be preparing their own responses — both legal and political.

But the trick for both men will be to calibrate their statements appropriately in the moments after the decision is announced. And that won’t be easy if the court’s decision is a complicated one affecting different provisions in different ways.

And the trick for the 50 million people who currently lack health insurance will be either to calibrate a game plan for hanging on until 2014 if the ACA survives, or coordinating a more open-ended agenda for the rest of their foreshortened lives. Whatever happens, the Obama family and the Romney family and the Supreme Families and the Congressional families and crime families of all stripes will all maintain their own guaranteed health coverage today and for thousands of tomorrows.

A new report by Families USA estimates that lack of health insurance now accounts for 26,000 needless deaths every single year in this country. These are working age people in the prime of their lives. (25-64). Although this number is about seven time as high as the tally of those killed in the 9/11 attacks, their deaths simply don't garner anywhere near the same amount of attention and government response. These deaths are not a national emergency because they are mundane, protracted and lonely deaths. And our government likes its crises to be dramatic, immediate and profitable.

Sick and poor people do not have a lobby, nor a newspaper column, nor a seat on the cable talk shows. And if they're uninsured, they're dying off at the rate of three per hour. They're being whacked at about the same rate as in an average Sopranos episode.

We spend the most money on health care of any civilized country, yet we have the worst results in terms of morbidity and mortality. No politician can spin those stats, so they just ignore them, and campaign, and echo the words of mob boss Tony Soprano: "Let me figure out how to take care of you."