The debate over healthcare reform is finally being heard before the Supreme Court this week in what some courtroom analysts are calling a marathon three-day session of oral arguments.

That only goes to underscore the complexity, but also the gravity of the issues the law presents. After what feels like an eternity of name-calling and recriminations by political pundits, the law will finally receive some measured and intelligent debate that is missing at times in much of the rhetoric to date.

This won't be Gore v. Bush. It is a political hot potato, but the court is under no rush to judgment as it was in that case.

The one major issue being argued today before the court is the individual-insurance mandate. Among the requirements of the Patient Protection and Affordable Care Act, the law requires individuals to buy insurance and is developing health-exchange-insurance groups to make coverage available and affordable where it isn't today.

That one piece of the legislation has a significant group of people in a state of lather, accusing the Obama administration of trying to impose a socialist, European healthcare system on Americans. The libertarian core feels it is just another attempt to trample on their rights to decide what is best for them and how to spend their money.

In addition, there are more than a few businessmen, including insurance brokers, who believe this is a bad piece of law and join the libertarian crowd in wishing that the Supreme Court overturn the law.

Arthur Postal wrote a compelling piece yesterday saying that despite all the protestations about this the law, ultimately, the court will uphold it because Congress does have the right to regulate interstate commerce, and there is an abundant amount of case law to support that position.

Others strongly disagree. This has been, and continues to be, an overheated issue, and this debate has centered upon the wrong issue. The question we should be asking is whether healthcare is a business or health issue.

Whenever I listened to a debate about healthcare reform during a meeting of the National Association of Insurance Commissioners, the former insurance director for the state of Illinois Michael McRaith, who now heads up the Federal Insurance Office, would note, “People don't decide when they are going to be sick.”

We may not like the idea of being told that we have to buy something, but unlike most other forms of insurance, your health is something you don't have much control over after it goes bad.

Lose your car and catch a ride with a friend. Homeowners can choose to rent instead of buy.

Have a heart attack or serious accident and there are limits to the efficacy of home remedies. And we're all trying to avoid the ultimate alternative.

For those without insurance, there is the charity of others, but at a time of limited municipal budgets, the avenues for help are closing and those who can least afford insurance for quality healthcare remain the most vulnerable.

I recently learned that one of my siblings no longer has insurance because the state plan she obtained insurance through is no longer extending coverage to someone in her income bracket. And her job offers only an expensive supplemental plan.

She says she knows it's time to move on from her job driving a school bus and find a new career that offers work with a decent healthcare plan. But my question is what does she do in the meantime?

There are close to 50 million Americans asking that same question today. They don't need a debate, they need answers.

No matter what the court decides, one thing has not changed: the current rhetoric aligned against the Patient Protection and Affordable Care Act is no closer to an effective solution to making healthcare available and affordable than it was before the act was passed. At least we have something on the books now that puts us in that direction. It's not perfect, but it's better than the alternative.

Special Reports /

Asking the Right Question

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