Why are people so worked up over the freedom to be a free rider? After all the newsprint, pixels and hot air devoted to this issue, I still don’t understand how health insurance regulation became a test of our fundamental freedoms.
I understand there are constitutional issues to be untangled involving the Commerce Clause, the 10th Amendment and the Anti-Injunction Act of 1867. There are enough legal issues in the trial of the Affordable Care Act to occupy the Supreme Court for three days of debate and to keep armchair legal analysts spinning for months.
I understand there are politics and corporate interests involved, just as there have been for the 40 years Washington has been debating health care reform, though never as intensely as in the past three years.
But even after all the newsprint, pixels and hot air devoted to this issue, I still don’t understand how health insurance regulation became a test of our fundamental freedoms.
I got a fundraising email from Michele Bachmann the other day calling "Obamacare" “the biggest invasion into our personal lives.” Can anyone explain to me how Americans like Bachmann, who wouldn’t think of letting their families go without health insurance, who actively consent to being virtually strip-searched every time they ride an airplane and passively consent to having all their emails data-mined by the NSA, can call a requirement that they buy health insurance — which they are already buying — “the biggest invasion into our personal lives”?
“It took hard work and perseverance to achieve our freedoms and now they are coming to an end!” warns the writer of a recent letter to the editor.
Hyperbole has now reached the highest court. Justice Anthony Kennedy said Tuesday that the individual mandate “changes the relationship of the federal government to the individual in a very fundamental way.”
So I’ve tried to figure out what Fundamental Freedom is at risk from the dreaded individual mandate. I can’t find it in the Bill of Rights. It’s not one of FDR’s Four Freedoms.
Near as I can tell, what’s at risk is the freedom to save money by not buying insurance, then count on the taxpayers and those who purchase insurance to pay for your visits to the emergency room and your stay in the ICU.
I understand that some religious leaders don’t like the minimum coverage requirements being set, as the law prescribes, by the Department of Health and Human Services. I understand many people can get upset over anything described as a threat to religious freedom.
What I don’t understand — and it’s not for lack of trying — exactly what religious freedom is being threatened.
Near as I can tell, it’s the freedom to make it hard for other people to practice birth control.
I can talk health care policy for hours on end, which puts me in a distinct minority. There are things I like, and things I don’t like, about what both sides are now calling Obamacare. It wasn’t my first or second choice for fixing our flawed health care system. But it was the best the Congress could do and will end up helping millions of people.
What I don’t understand is the hysteria. I guess I’m guilty of, as Jon Stewart said the other night, “bringing a provision to a principles fight.”
The fear and loathing of the individual mandate is especially hard to take seriously here in Massachusetts. We’ve had an individual mandate for years, and all it means is a simple form included with our state income tax filings.
Religiously affiliated institutions have had to include contraceptive coverage in employee health insurance here since 2002, and nobody squawked about government treading on their religious freedom until a few months ago.
And, if the individual mandate is thrown out and everyone says insurers can’t be expected to provide coverage for pre-existing conditions, remember this: Here in Massachusetts, coverage of pre-existing conditions has been required since Michael Dukakis signed his health reform law, 18 years before we got an individual mandate. Somehow we’ve survived.
Of course, thanks to "Romneycare," 98 percent of Massachusetts residents have health insurance, with subsidies for families that need them. Those who refuse on principle to insure themselves are welcome to pay a fine, based on income, of as much as $1,212 a year, which is well below the cost of insurance.
Most of us go to the same physicians and deal with the same insurance companies as before Romneycare. I’ve yet to meet anyone who feels their relationship with state government has been changed in a “very fundamental way.”
So really, what’s all the fuss about?
America has the most expensive, inefficient health care system in the developed world. We spend 17 percent of GDP on health care, while no other country pays more than 12 percent. People without insurance consume $116 billion in health-care services each year, with 63 percent of their bills paid by taxpayers or by those who have insurance. More than 40 million Americans don’t have insurance — and the “freedom” to be a free rider and let everyone else pay your medical bills has very little to do with it.
I understand some people are confused by complicated policy discussions but comforted by their embrace of core principles.
But I can’t help thinking what’s really going on here is simple politics: Most of these folks just believe this prescription for our health system’s woes was signed by the wrong president.
Rick Holmes, opinion editor for the Daily News, blogs at Holmes & Co. (http://blogs.wickedlocal.com/holmesandco). He can be reached at email@example.com.