Mandates and recent lower court rulings

Below is a posting I did on the Muftic Forum Facebook profile Dec. 13, 2010. In addition to the comments in the posting are some more thoughts.  Besides expanding the size of the pool, the other advantage of requiring all to carry health insurance is that everyone is paying something they can afford into the system...which helps pay for health care reform. Before healthcare reform, 30 million paid nothing in premiums; with Obamacare, all but the very poor of them will pay something if not all toward their premiums. Only the very poor get off with not paying something toward their insurance; everyone else pays in with premiums based upon their ability to pay taking in consideration family size and income level.  For those not able to afford health insurance, if they buy insurance in the exchange, they will be discounted (subsidized) to the level they can afford. Everyone else who does not get any subsidy will still benefit from the stiff competition of the private insurers who compete within the exchange for their business..  That gives consumers a competitive market from which to choose. 
"About the recent Federal judge ruling on insurance mandates: While the judge ruled one way, two other federal judges have ruled another way, 18 more cases are still in various courts.  This pretty well makes sure that the issue will go before the Supreme Court.
I will not second guess the legal arguments, but I will comment on the fall out if the mandates are thrown out:
Above all, freeloaders will run up the cost making it nearly impossible to insure those with pre-existing conditions and the entire cost of the health care system will be impacted.
 The reason is that healthy and well as unhealthy must be included in a big pool to make the odds work and spread the risk around.  Freeloaders who choose not to participate will get sick, go to the ER, and, as we know, use of the ER now is extremely expensive medicine. Patients who go there are usually already very sick, prevention is not included in ER treatment, and abusing the ER as primary care doctor is expensive in itself. This is one reason health care costs twice as much per capita as it does in other industrialized nations.
The other cost is in covering those with pre-existing conditions. It will not happen without a large infusions of tax payer money or some other method of funding. One way to do it would be to establish high risk pools and subsidize them, segregating those expensive to insure from the others.  Republicans have proposed covering their cost by reforming mal practice or increasing cross state competition, which I support...in any case, but whether it could raise enough money and how it would do it is a very big question that has not been resolved or have projections been made by the Congressional advisers (Congressional Budget Office)  or independent sources, that I know of.
Otherwise, the state by state exchanges, the other provisions to ensure the uninsured who did not have pre-existing conditions, extending coverage to those up to 26 years old, and the consumer protections which are not conditioned upon pre-existing conditions would continue.  The state exchanges would exclude those with pre-existing conditions and bump them into some kind of high risk pool covered by tax dollars.However, others may enjoy the lower prices provided by the pools which give the private sector a level field to provide choices that meet certain standards in an above board competitive system.   Those not insured by their employers who are able to qualify for insurance may still find policies that are affordable in the exchanges.
 What I find angering is the glee many express at the possibility of the freeloading ruling succeeding.  It appears to me that they want health care costs to rise and those with pre-existing conditions to cost us more than Obamacare. They will not kill health care reform; just cut out the savings and make it more costly than it needs to be.
The only ones winning if the Supreme Court rules against the mandates are those who intend to freeload the system.  The rest of us will have gotten screwed."