Can't diagnose court's ruling

Now it's time to nervously take a seat in the waiting room while the Supreme Court decides whether to perform misguided elective surgery, or worse, on President Obama's health-care overhaul.

Last week's historic, three-day argument over the challenge to the landmark 2010 law by 26 Republican-led states made one thing clear: Everything's on the line in deciding the legality of the law's requirement that most Americans must acquire health insurance by 2014, or pay an annual penalty.

Along with that provision, designed to fairly spread the cost of health care and rein in runaway costs, the reform assures no one will be denied coverage. Those aspects, plus expanding government-run health care and creating subsidies so the working poor can buy policies, will mean coverage for 30 million of the uninsured.

Yet, despite those benefits when the law is fully implemented - and the fact that it's already two years into the roll-out - some justices entertained the unfathomable notion that the whole law could be struck down. "Take out the heart of the statute, the statute is gone," said arch-conservative Justice Antonin Scalia.

But anything less than upholding the entire Affordable Care Act could have dire consequences for a nation already struggling to keep pace with rising health-care costs, chronic disease, and job-lock due to the lack of workplace insurance at many companies.

Without the mandate, says the Massachusetts expert who fashioned that state's successful universal coverage plan, the numbers of uninsured will rise as workplace-based coverage shrinks even further. That will mean millions more people at risk of serious illness and early death. It will trigger a dramatic increase in insurance premiums when compared with the full reform.

It's clear that, without the mandate, many insurers could not survive, if they still had to serve all comers. Especially the young could wait until the last moment to jump into an insurance pool.

To that extent, Scalia is right about the importance of the mandate, even though there could be other mechanisms to make sure most people buy insurance. The justice and other critics, however, are far off-base in suggesting that the insurance penalty represents any number of supposed threats.

In fact, a Robert Wood Johnson Foundation study shows the vast majority of people will be able to comply with the insurance mandate.

With health insurance, it's not a question of if, but when, you will need it. Car accidents, by contrast, are not a certainty - yet states require insurance to drive. Would anyone seriously suggest that a driver would be able to buy insurance right after crashing the family minivan?

Nothing argued in court last week changed the fact that this nation desperately needs to enact health-care reforms to deal with a crisis of cost, quality, and access to medical care in the only Western nation that hasn't provided universally for this most basic human need.

It will be shocking if common sense, legal precedent, and the nation's best interests are tossed aside by the high court. The right course would be to put aside partisan politics and allow the overhaul that's already benefiting millions of Americans to proceed.