The Setup

My recent trip to the White House has gotten me all fired up politically. Okay, not really, but it reminded me of this deeply irritating failure of logic in the soon-to-be decided (or maybe already-decided-but-soon-to-be-revealed) Supreme Court health care case which, as a citizen who went through 10 layers of security before eating two squares of what I believe was Pepperidge Farms Coconut Cream Cake (albeit on a silver tray), I now feel compelled to point out.

What Health Care Haytas Say

The Affordable Care Act penalizes people for not purchasing something – in this case health care – and that is beyond the bounds of what the Constitution allows.

Back Up And Tell It Right

Incorrect.

When you are purchasing any kind of insurance – health, auto, life, your chest hair if you’re Tom Jones – the product of the transaction is not the tangible policy but rather the intangible, immaterial consequence of the policy. In the same way when you play blackjack, you’re not purchasing chips but rather “opportunity,” the purchase you are making when you buy insurance is “peace of mind” and not “piece of paper.” When you buy auto insurance, for example, you are purchasing a certainty of a maximum outlay in the event of an accident, i.e. worst case scenario, I pay my deductible and the insurance company is responsible for everything else (within the limits of my particular policy).

Here is why the “you’re charging people for not purchasing something” shizz is completely wrong. Because Congress has mandated that all hospitals must treat all Americans regardless of ability to pay, we all ARE, in fact, getting precisely what insurance provides – peace of mind. We know that in the event of any kind of health crisis, we will always get treatment. Therefore, the Affordable Care Act, far from charging people for not purchasing something, is simply making the billing transparent on something we’re all getting anyway.

Far from one Justice’s assertion that the Affordable Care Act created a market in order to regulate it, we, in fact, created the peace-of-mind market years ago when we insisted on putting a primacy on human life and pain above mere money by forcing hospitals to treat people regardless of their ability to pay. The only people who could really make an argument for not having to pay the penalty for not having insurance are Christian Scientists for whom “peace of mind” is purchased by their faith.

In order for the “charging people for not purchasing something” argument to work, Congress would need to repeal the law insisting that hospitals provide care regardless of ability to pay, i.e. it would need to give us a choice to have peace of mind or not, a choice we do not currently have. Here’s what the world in which we have that choice – the one where the “charging people for not purchasing something” logic would work – would look like: In a parallel to the auto insurance market where drivers can weigh the risk of not having insurance – a totalled car which they can’t afford to replace – versus the cost of having it, so would we all be able to weigh the risk of collapsing in the street and being left to die there for lack of funds or having broken bones and screaming outside of hospital doors because of an inability to pay versus purchasing peace of mind by getting insurance.

Until Congress chooses to place us in that world, all Americans are getting precisely what insurance provides, so the argument against all of us paying for the peace of mind we’re getting anyway is what again? Here’s hoping logic prevails…