By Richard Downes, Washington Correspondent

So the Supreme Court of the United States will now be the final arbiter of whether President Obama’s modest health reforms will stand or fall. After three days of submissions and argument the judges will come back with an adjudication around the end of June. Oh yeah – and there is an election this year.

An election for the Presidency of the United States! If ever there was the clear basis of a conflict between the elected branch of government and the judiciary, this is it. Can you imagine the effect of the Court striking down the law in the middle of the election year?

In a mature democratic system like the US, the institutions would survive, but not without strain.

On a personal note, the American medical system has baffled and infuriated me. Not only is it absurdly expensive but in my experience some of those who administer it are incompetent and obstructive.

Who would have thought that one could lose an application sent electronically? The health insurance company involved lost my details THREE times. I abandoned that route and eventually found an insurer. I have a health insurer. This is a purely commercial transaction. I give them money and they give the minimum of service. The minimum.

They charge a fortune but the system is designed to suit the insurers. The judges won’t change this but something has to change in America’s system. It eats up 14% of national wealth every year and acts as a drag on the rest of the economy. It is sick.

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