The Porter Bureau

A friend of mine on facebook asked me the following question: “How do you feel about proposed plans to force people to buy health insurance?” The salient part of that question is the word “force,” as in government mandate/intervention into our lives. That may not have been his intent (if so, I apologize, Joey), but it prompted the following horribly excessive response which offends every standard of facebook netiquette. Sorrys all around. Not wanting to let a good ramble go to waste, here it is again:

A loaded question to be sure. But I personally have no problem with “forcing” people to buy health insurance. When I left my job a few years back to go to school full time, I tried to buy private insurance for myself and my family. I was denied because I was (still am, sadly) over weight. Diana was denied for a “pre-existing condition” (she had been treated for infertility… but we were applying for a plan that didn’t cover maternity). And Byron was denied because as a minor he couldn’t be the primary holder on a policy. I desperately WANTED to insure my family, but I couldn’t. I am convinced that the majority of the 45 million Americans who don’t have health insurance would gladly pay for it if they could find a policy which would cover them at a reasonable price.

But you’re right, there is a small minority out there who will take umbrage at the gov’ment taking away their God-given right to not do anything that they don’t want to do, not matter how socially responsible or reasonable. My brother-in-law, who I have the greatest affection for, is one of them. In fact, when we were in Colorado this summer he and I got to talking. He told me point blank that if a law were passed requiring him to insure himself, his wife and his five children, then he would revolt—and trust me, he has the firearms to stage his own personal Bull Run. (Ironically, he sells health insurance for a living.)

But then I asked him what he would do if one of his kids had a major illness and had to be hospitalized for an extended period of time. Wasn’t he worried that he would quickly roll up tens of thousands of dollars in medical bills that he couldn’t afford to pay? Yup, he said, but that was a risk he was willing to take. If that happened and he had to declare bankruptcy, then he felt he should be allowed to live with the consequences of his choice not to purchase health insurance.

I followed up (respectfully, since I’m pretty sure had a hand gun or two out in his car) by pointing out that it wasn’t he who would have to pay for his irresponsibility. If he filed bankruptcy, what did he think would happen to all those bills? Would they just drift away into the wind? Who would cover that doctor’s time? His kid’s medications? The hospital fees?

He laughed because as an insurance salesman he knew the answer better than I did: “Those of you who pay for insurance would.”

And if, I continued, heaven forbid it was one of his daughters who got sick and not him, then in fact she would be the one to suffer the consequences, not him; she would now have a “pre-existing condition,” preventing her from getting the long-term care she needed.

No one tells this guy what to do, but I could tell that he recognized that this wasn’t just an issue that affected him and his family. His responsibility, or lack thereof, directly affected everyone around him. “Personal responsibility” and “don’t tread on me” attitudes simply don’t apply in this case because the system is so interconnected. To misquote John Donne, “Do not ask for whom the bill comes, it comes for thee.”

Put in that context, I don’t have a problem with “forcing” everyone to get health insurance any more than I have a problem “forcing” drivers to insure their vehicles. Except, of course, unless there is no public option. Then it’s just a bonanza for the insurance companies who will gain 45 million captive customers with no one to tell them not to squeeze every penny they can out of the public teat.

Sadly, this is one of the soberest and well-informed debates over health care reform you’re likely to see (at least if you watch Fox News that is).

David Brooks, or as I like to call him, “the thinking man’s conservative,” recently wrote an op-ed piece comparing the state of the health care system in America to a horde of trampling rhino’s charging through our national village. An apt metaphor to be sure:

The rhinos are closing off your future. As the White House folks say, health care premiums have doubled over the last decade. The government is saddled with $36 trillion in unfunded liabilities.

So your only question should be: Where do you find a tool or weapon big enough to stop the rhino stampedes? You know the problem is big, and you figure the response had better be gigantic.

Then you look on Capitol Hill and you see a bunch of popguns. The politicians describe these big ugly problems, but when it comes time to talk about their remedies they tell you: Don’t worry. Nothing’s going to change. In other words, we’re going to eliminate the biggest, hairiest, most entrenched problem in the country without fundamentally changing the system and without asking for sacrifice from anybody.

Good luck.

He has a critical point. If whatever group-think, underfunded, compromise laden, don’t scare the old folks worded, “slippery slope to socialism” redacted bill that comes out of congress doesn’t have the strength to actually address the issue, then the results will be all too predictable.

But, for all of Brooks’s insight and keen analysis, I dare you to try to read his article without the following song in your head. (It won’t work, I tried.)