Thursday, April 15, 2010

Tea Party and Health Reform

Yvonne Abraham, a columnist for the Boston Globe, attended the Tea Party gathering yesterday on the Boston Common. Abraham reported a fascinating interview with Donna Tripp, a 55 year old Massachusetts resident. In what follows, I've interspersed my comments in italics:
Like everybody else at the rally yesterday, Tripp hates, hates, hates the health care overhaul recently signed into law.

"This country is taking a hard right turn for socialism,’’ she said. “I don’t want to be told to buy a service I don’t want. America is about freedom of choice."

Tripp, 55, already lives in a state that requires everybody to buy health insurance, but she refuses to do it.
As I've discussed in previous posts (here, here , and here), the cumbersome and confusing requirement that individuals acquire insurance or pay a penalty is actually a tax in drag. We in the U.S. are so averse to taxation that Massachusetts (2006) and the federal government (2010) chose not to finance the quest for universal coverage through a general tax. The mandate isn't a requirement to purchase a consumer good - it's an awkward effort to create a public funding stream without making it obvious that it's really a form of taxation. As I've said before, unless one opposes universal access to coverage, the alternative to the mandate as some form of single payer tax. Donna Tripp knows this and doesn't evade the issue!
"I’m healthy," she said. When her husband went to Canada for prostate cancer treatment five years ago, they paid $25,000 out of pocket.

But what if she got really sick — if she needed, say, heart bypass surgery, which could cost more than $100,000?

"I’d mortgage my house,’" she said. And if that wasn’t enough?

"I guess I’d die," she said. "But under our Constitution, I should be able to take that risk."
Donna Tripp deserves credit for being consistent! She understands and accepts the consequences of choosing to be uninsured. Of course, when the need for bypass surgery or a potentially curable cancer actually emerged, Ms. Tripp might feel differently. But she instructs us in advance to respond - "Donna, we'll miss you, but it was your choice!"
More likely, Tripp would get her treatment, and if she couldn’t afford to pay for it, the rest of us would pick up the tab.

That’s how this country is set up: According to the preamble in the little Constitution the kind man gave me, we are all about promoting "the general Welfare."

Or maybe that’s the country we used to live in.
As a country we're not prepared to do what Donna proposes - let people sink or swim in accord with their ability to pay for health care. We're all free to refuse any proposed health care interventions, but as Yvonne Abraham points out, the Preamble of the Constitution commits "We the People of the United States, in Order to form a more perfect union [and] promote the general ordain and establish this Constitution..." As a civilized society we're finally moving towards universal health protection, which, like education, is a basic component of "general Welfare." The Declaration of Independence likewise committs us to promoting "life, liberty and the pursuit of happiness."

It's hard to pursue happiness when we're dead from a potentially curable condition!

Donna Tripp, like all Americans, is entitled to reject life saving bypass surgery. But our Constitution requires us to make medical care available to her and her fellow citizens, just as it requires us to "insure domestic Tranquility [and] provide for the common defense."

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