Judges and the health care law

Ezra Klein has numerous posts on the legal analysis of the Vinson ruling in Florida.  This post goes over the weak link in the Judge's opinion.  The summary:

If you want to follow this argument a bit further, Simon Lazarus delves into more detail on the some of the past rulings and statements that Roberts, Kennedy and Scalia would have to wipe away to rule against the Obama administration in this case. The result, he says, would be not just a ruling against the legislation, but a ruling that would "exhume the long-dead and discredited doctrines that the pre-New Deal Supreme Court deployed to overturn laws that prohibited child labor, prescribed minimum wage levels and maximum hours."
My understanding is that many libertarians and conservatives would like to see the Supreme Court return to a limited understanding of the Commerce Clause closer to what prevailed in the past. But until now, the Supreme Court hasn't shown much interest in that project. In theory, they're more persuaded by the precedent they've signed their names to than to the first principles that Vinson invoked in his decision. But in practice, on this particular case, for this particular law? Who knows.

I don't know much about the law and Supreme Court precedent. I am a farmer and an engineer.  But I guess if I were forced to try to explain why the individual mandate is constitutional under the commerce clause, I would go with the concept that since hospitals are required by law to treat patients in emergency rooms, a person who doesn't have insurance and resides in one state will quite possibly end up in another state, where they will end up in the hospital because of some emergency.  If this occured frequently, a state could not prevent people from another state from travelling there and potentially burdening the citizens of their state with the individual's care.  I am sure that is not a workable rationale, but I don't know what other explicit commerce clause arguments would work.

What disturbs me most about this whole issue, is that it lays bare the naked partisanship in our court system.  Two rulings by democratic judges finding the law constitutional, two rulings by republican judges finding it unconstitutional.  It may get decided by one man, Justice Kennedy.  I personally feel the mandate is inherently a republican idea, insisting that it is an individual's responsibility to carry health insurance.  Personal responsibility has always been the calling card of republicans, and pushing people to private health care insurance also strikes me as republican.  It was the heart of Romneycare, and if most individual states went the way of Massachusetts, I think the commerce clause argument would be stronger.  But at the moment, the GOP is freaking out over this and 1990's platform positions are now unconstitutional.  Ezra's speculation that the court may well throw out sheaves of precedent is a fear that I think is very valid.  An outcome like that, following the Citizens United ruling, would lay bare who the activist judges really are, and we would have a country with 310,000,000 people operating under restraints from a time when the country had 120,000,000 people.