HEALTH CARE/Joan Retsinas

The People v. Obamacare

As Obamacare wends its way through the judicial labyrinth, let’s glance at the plaintiffs. (“Bankruptcies hit people challenging health law’s insurance role,” Bob Drummond, BusinessWeek, March 23).

Not the state attorneys general. Not the small business federations. But the all-American Joes and Janes named in the suits. They don’t want Uncle Sam to force them to buy health insurance. Ironically, they could just as easily switch sides, demonstrating the urgent need for Obamacare.

One plaintiff, Mary Brown, walks in the shoes of Emily Litella. Remember her? Saturday Night Live’s iconic “Oops” newscaster (a.k.a. Gilda Radner) would read a breaking news announcement: “We Need to Protect Children from the Violins on Evening Television.” She would rant: why don’t we want children to hear and see violins? When her sidekick whispered “violence,” she turned to the audience and blithely said, “Never mind.”

Mary Brown is another “oops” woman. By now she has receded into the archives of political trivia; but in the not-too-distant past she led the “Ban Obamacare” movement. She considered insurance a burden she didn’t need, didn’t want. A veritable Independent Woman, health-wise.

A lot has happened since Floridian Mary Brown signed on as a plaintiff. Her auto repair business failed. In September she filed for bankruptcy. Among her bills: $4,700 for medical expenses. Admittedly, those bills — $4,700 are minuscule by medical bill-standards — did not drive her into bankruptcy, though medical bills do propel many Americans down that route. (She did collect unemployment insurance; she didn’t reject that.) But hospitals, physicians, and, ultimately, the rest of us, must absorb those bills. Mary Brown, moreover, was fortunate: a cardiac operation, an appendectomy, a year of chemotherapy would have sunk her into a fiscal abyss. And the blithely uninsured Mary Brown might have regretted her stance. An Oops moment.

Meet Charles Edward Lee, a truly principled plaintiff. His take: God, not Uncle Sam, will provide. By “provides” he includes not just spiritual wellbeing, but physical and financial too. Unfortunately, God didn’t oversee Charles Lee’s finances, or maybe bankruptcy was part of a divine plan for Charles. His Lawn and Tree Service, in Texas, failed. In September 2009 he too filed for bankruptcy. If catastrophe befalls him – he slips on a banana peel, a drunken driver rams into his car, the stomach ache turns out to be a tumor – Charles Edward Lee will accept the consequences. According to his lawyer, he wants only prayer, not treatment. But if he were to change his mind, hospitals and clinics would treat him, leaving the rest of us to pay those bills.

Attorney John Ceci also signed on to the cause. He follows in the heels of another American icon, the gambler. Although he could have afforded the premium, he opted out. In an affidavit, he declared “I would prefer to purchase a new car rather than pay a monthly health care premium.” Presumably he replaced his aging Honda.

The economy derailed Ceci’s business: like Charles Edward Lee and Mary Brown, John Ceci filed for bankruptcy. Unlike Mr. Lee, Mr. Ceci has not vowed to forswear treatment if he needs it. Maybe, since he specializes in bankruptcy law, he would once again declare his way out of debt. Among the 44 million people under age 65 who don’t have health insurance, the law’s challengers have found a few people — all healthy — who could have bought insurance, but didn’t. They trust God, Lady Luck, or bankruptcy court to pull them through. The nine Supremes will be deciding the nature of markets: must people be forced to buy anything, no matter how beneficial: broccoli? Insurance? But the consequences of poor nutritional choices fall on the consumer. Risks after all are not certainties. People who dine solely on cheeseburgers can live to be centenarians; vegetarians can die at age 50.

Healthcare, though, is not a classic market. Hospitals and clinics must treat people without insurance. The person who spurns broccoli accepts the risk; the person who spurns health insurance passes that risk on. To make healthcare a classic consumer market, clinicians would reject anybody who couldn’t pay – and, given the costliness of much life-saving therapies – that would mean anybody without insurance. Many of the Tea Party Republicans want such a market; indeed, when Wolf Blitzer asked Ron Paul whether he would let an uninsured injured man die in the streets, audience members cheered. But in that classic market, I suspect these plaintiffs, if ill, would plead for, not against, Obamacare.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, May 1, 2012