Guest Columns


No insurance? No health care? No way

The Colorado Statesman

As I was watching the TEA Party debate among the Republican candidates for President, it became evident why Sarah Palin and her admirers were so exorcised last year regarding the possibility of death panels. They must have known what they might expect if any of them were selected to serve on these juries. Little wonder they were alarmed. The critically ill, when uninsured, would not pass GO, nor collect $200, but would be promptly delivered directly to the closest mortician.

It was more than a little startling when a significant portion of the audience made it clear that the hypothetical young man arriving at a hospital in a coma should be left untreated if he lacked insurance. Setting aside the fact that it is impossible to provide convincing evidence of insurance while one is in a coma, prior to Obamacare we know that such a dereliction of personal responsibility may have had more to do with the presence of a pre-existing medical condition than a cavalier disregard for the value of health insurance. Presumably a history of diabetes or childhood leukemia, which prevents any young man or woman from securing insurance, would prove a death sentence if he or she were critically injured in an accident.

Obamacare promises to correct these injustices, but this change is still some years off, and it isn’t clear whether the requirement for insurors to underwrite everyone will come with premiums the average American can actually afford. Thus, the adamant demands for a public option on the part of many Democrats. But, none of this seems to matter to our TEA Party friends, who view such requirements as onerous regulatory interference in the health care marketplace. They continue to howl for immediate repeal.

Their prescription for our health care system appears simple enough: the uninsured are irresponsible louts and should be left to their fate, even when that results in their premature demise. If you view health care as just another commodity, similar to coffee beans or precious metals, there is a certain Darwinian logic to this approach. Restricting medical services only to those who can afford them would dramatically reduce the total cost of the American health care system. It would have to be considerably cheaper to keep the healthy, healthy, and leave the sickly to fend for themselves.

It is difficult to believe a majority of Americans, outside of the TEA Party, would support this policy. While it is true that a substantial portion of health care costs reflect the consequences of poor behavioral choices, it is equally true that illness is often the result of receiving a losing ticket in the genetic lottery that, for better or worse, is our personal and unique inheritance and over which we have no control. Looking the other way while poor health removes these losers from our gene pool would likely improve species health over several generations; but it is difficult to see how this option constitutes an improvement over ‘death panels’?

I’ve only spent a single night in a hospital bed in my entire life, and that occurred when my appendix was removed at the age of 17. Insurors have pocketed tens of thousands of dollars in premiums from me during my working life without having to provide more than a few flu shots and a handful of statins to control my cholesterol. I achieved this fortunate record without pursuing a particularly healthy regimen. By contrast, my brother ran marathons, gobbled supplements, rarely drank, never smoked and could have been a poster boy for mature fitness. He had the triple bypass several years ago. Go figure.

A moral calculus premised on an individual’s ability to pay for health care seems a dubious ethical proposition in any religious tradition. In fact, MEDICARE was implemented to correct for the fact that our employer based medical insurance system left the elderly without coverage at the very point in their lives when the demand for services would grow and just as their ability to pay for them was reduced by retirement. There is general agreement that fairness requires affordable access to health care for our senior population. Why not for everyone?

Miller Hudson has written a healthy number of articles for The Statesman over the years.