The Supreme Court's hypothetical mobile phone mandate

By Brian Dolan

Brian Dolan, Editor, MobiHealthNewsQuick note: Be sure to tune in to today's complimentary MobiHealthNews webinar, Meaningful Uses for Mobile, for a discussion on how two of the biggest topics in healthcare today intersect: Meaningful Use and mobile health. We'll kick things off at 2PM ET. Complimentary Registration right here.

While the Supreme Court has been hearing the case for and against the individual mandate for health insurance this week, we had no plans to cover the arguments since they had little to do with this publication's mandate. That changed on Tuesday when Chief Justice John Roberts suggested that if the government can require individuals to buy health insurance, it could use similar reasoning to require individuals to buy a mobile phone.

Here's how the Chief Justice made his case, according to the transcript from Tuesday's proceedings:

CHIEF JUSTICE ROBERTS: Well, the same, it seems to me, would be true say for the market in emergency services: police, fire, ambulance, roadside assistance, whatever. You don't know when you're going to need it; you're not sure that you will. But the same is true for health care. You don't know if you're going to need a heart transplant or if you ever will. So there is a market there. To -- in some extent, we all participate in it. So can the government require you to buy a cell phone because that would facilitate responding when you need emergency services? You can just dial 911 no matter where you are?

GENERAL VERRILLI: No, Mr. Chief Justice. think that's different. It's -- We -- I don't think we think of that as a market. This is a market. This is market regulation. And in addition, you have a situation in this market not only where people enter involuntarily as to when they enter and won't be able to control what they need when they enter but when they --

CHIEF JUSTICE ROBERTS: It seems to me that's the same as in my hypothetical. You don't know when you're going to need police assistance. You can't predict the extent to emergency response that you'll need. But when you do, and the government provides it.

Whether or not this hypothetical sways you or seems irrelevant to the federal health insurance mandate, by making this argument the Supreme Court Justice called attention to the essence of mobile health. Immediate access to emergency services is the tip of the ice berg for mobile health services, which are increasingly expanding to include anytime, anywhere access to a variety of necessary health information and services.

While the suggestion of a mobile phone mandate was certainly intended to be provocative, it's worth pointing out that the government already provides mobile phones to people in need. Far from a mandate, but recognition of the device's importance. The Lifeline program now benefits millions of people who must meet federal low-income guidelines or qualify social service programs like food stamps or Medicaid. A 2009 report in the New York Times referred to it as "a form of wireless welfare that puts a societal stamp on the central role played by the mobile device."

Roberts obviously understands that central role.

Perhaps the outcome of the Supreme Court case will be that the federal government cannot mandate the purchase of health insurance. Perhaps not. But it is telling that -- for the Supreme Court Chief Justice, anyway -- the short list of necessary health-related services today includes a mobile phone subscription.

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