What's in a name? A health-care law by any other name ...

When a Virginia federal judge decided last week that it’s unconstitutional to require everyone to have health insurance, some wondered why it’s constitutional to mandate car insurance and Social Security.

Car insurance isn’t at issue. It’s required by states and the 10th Amendment sets aside matters not covered by the Constitution to them. But how did Social Security, which requires everyone to have old age, survivors and disability insurance, survive for 75 years?

In fact, it very nearly didn’t. Social Security barely avoided being declared unconstitutional by the Supreme Court in its second year. The vote was 7-2 and 5-4 in two cases decided on the same day in 1937.

The first found the Social Security Act, by providing insurance and unemployment benefits, promoted the general welfare, which is enshrined in the Constitution and very desirable during a Depression. The second said financing Social Security with a tax was consistent with the Congress’ constitutional right to raise taxes. Citizens were not required to buy insurance policies but Congress could tax them in order to insure their old age.

The new health-care law, however, doesn’t tax us to pay for health insurance premiums. It requires us to buy the insurance, and opponents argue if the government can make us buy insurance, it can make us buy anything else and that’s unconstitutional. We’ll see.

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And while we’re discussing the health-care law and Social Security, what’s with those two names? Social Security sounds official, yet warm and welcoming. The health-care law isn’t even capitalized.

In most news stories, it’s just called the health-care law or derisively, Obamacare, but hardly anyone knows its real name. Maybe it’s because it’s had two awful names, the Patient Protection and Affordable Health Care Bill, which was amended and became the Health Care and Education Reconciliation Law.

Not quite as catchy as the GI Bill of Rights, Lend Lease, Social Security or even the misleadingly named Patriot Act. And therein lies one of the many problems with the long-awaited law designed to improve the nation’s health care. To get people to understand what a bill or a law is all about, and maybe even support it, it’s a good idea to start with an understandable name and then see to it that your opponents do not define what’s in it.

Government documents have recently been trying to call this law without a name the Affordable Health Care Act for All Americans, but since the law has yet to provide affordable health care for all Americans and health-care costs seem to be going up, it hasn’t quite caught on.

What you call a law is important when you’re trying to sell it to the public. Roosevelt and the people around him knew that when they passed the largest government program the world has ever known, they did it in the midst of the greatest financial crisis the world has ever known and gave it a name everyone understood, Social Security. (It was introduced as the Economic Recovery Act — a good name — but changed to Social Security — a better name — before Congress voted.)

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Like Social Security and Medicare before it, health-care reform’s enemies have tried to label and define it. Social Security was seen in conservative circles as heralding a socialist America or worse. A leader of the U.S. Chamber of Commerce called it a plan to Soviet-ize America.

With unemployment twice as high as it is now, workers found notes in their pay envelopes warning them Social Security would cause more layoffs as employers simply couldn’t afford a Social Security tax in a Depression. But Social Security trumped all that, became the law and two years later, survived two Supreme Court challenges.

Many of us remember how Medicare was vilified as socialized medicine by everyone from the medical profession to the governor of California, Ronald Reagan, and we needn’t take that short trip down memory lane to recall last year’s many assaults on health care as socialized medicine with death panels.

And so, before other states join Virginia in declaring health care reform unconstitutional and the law goes to the Supreme Court for an almost guaranteed 5-4 vote, it might be a good idea to find it a better name.

Dick Ahles is a retired journalist from Simsbury. E-mail him at dahles@hotmail.com.

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