We all know that there's a huge problem with health care in the US, where more than 45 million people have no health insurance, in large part because they're too poor to afford it. And we all know that something needs to be done about it. But what?
Massachusetts has a plan: punish the victim. As the Washington Post reports:
Today, the home of some of the nation's most prestigious hospitals and medical schools becomes the first state to require its residents to have health insurance or face financial penalties. ... When Massachusetts residents file their state tax returns next spring, they must certify that they had acceptable coverage as of the end of 2007 -- or lose the $219 personal exemption. The penalty grows steeper in subsequent years, big enough, officials hope, to persuade most holdouts to get coverage.
And just how much steeper will those penalties become? According to Business Week:
Beginning in 2008, individuals who don't have insurance will be subject to a penalty equal to half the cost of health insurance. Last year, coverage for an individual ran about $4,000 a year, and nearly $11,000 for a family, according to the Kaiser Family Foundation. "That's a significant penalty," says John McDonough, executive director of Healthcare for All, a consumer advocacy group.
"Holdouts" is an interesting choice of terminology on the Post's part, especially considering this later excerpt from the same article:
Costs are still too high for some. Already, state officials expect to exempt 60,000 residents from the new mandate because they cannot afford the insurance at the going rates, even though they earn too much to qualify for subsidies.
Only in the US could someone look at the health care crisis and say, "The real problem here is all of those healthy, flush deadbeats who refuse to get insurance--so we'll penalize them for it and fix everything! Sure, they won't be able to afford a third BMW, but at least they won't be able to rip off the rest of us anymore by taking advantage of that great emergency room service." It takes real dedication to reach this conclusion despite the readily available and heartbreaking stories about why so many people lack insurance and are forced to live (or die) with inadequate health care.
The "holdouts" bit isn't the only instance of cynical doublespeak in the Post article, though. There's also this:
This is not the first time the state has attempted to tackle the problem. Nearly 20 years ago, then-Gov. Michael S. Dukakis signed universal health-care legislation that was supposed to bring coverage to everyone by 1992. But the law's requirement that employers provide coverage to workers or pay a tax proved unpopular, and it was never implemented.
The requirement "proved unpopular"? Gosh, with whom, exactly? I somehow suspect you've already figured that one out, but let's set the Wayback Machine to 1991 to verify the obvious:
The Massachusetts plan to guarantee health insurance for all, once
hailed as a model for the nation, is faltering under the weight of a
soured economy, a hostile new [Republican] Governor and the fierce opposition of
small-business owners, who would be required to pay for coverage of
employees. ... In the new economic and political climate, larger companies' support for the law has faded, and the owners of small businesses who long opposed it have intensified their attacks.
As the director of the Boston group Health Care for All observed, "The business opposition is more ideological than rational." And these (corporate) ideologues were victorious, as they usually are.
I've had my own Kafkaesque encounter with health care in the US. When I joined the ranks of the self-employed a few years ago, I had to go out and find health insurance for myself. The applications asked me to identify and explain every single incident in my health history, and because of my fatal flaw--honesty--I did. As a result I received a rejection notice from one prominent health care provider which said that because of my "serious medical problems" (e.g. a single back spasm I'd had while I was in my 20's) they couldn't offer me their standard insurance, but they might still be able to cover me under California's dead-end medical insurance program--albeit with exorbitant premiums. I wrote back and explained the facts, and they relented. Now, this was happening to me when I was young and in perfect health; I could barely imagine what it would have been like for someone who actually did have "serious medical problems" or significant pre-existing conditions, especially if they were within striking distance of the poverty line.
We can only hope that Sicko will refocus the health care debate on what this country really needs: not some half-assed punitive "mandatory health insurance" program that leaves private insurers in the driver's seat, but a genuine national health care program that gives all of us what the citizens of so many other nations have had for years.