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Death, taxes, and healthcare legislation

What would you pay to live forever?

OK, dumb question.

How about, what would you pay for a long, healthy life? Or, if you can imagine the Grim Reaper already hard on your doorstep, what would you pay to live even a little longer?

For most of human history these were all equally dumb questions. There wasn’t that much medicine could do to alter your fate. A cardiologist friend tells me it wasn’t that long ago that medicine reached the watershed moment where a visit to the doctor was finally more likely to save your life than kill you.

The turning point probably came around the middle of the last century. In the dark days before that the richest potentate could find a glamorous life coming to an early end, and there was little to be done other than gather the relatives. Death was a great equalizer.

Now here we are, with the brilliant men and women of the medical field able to perform miracles. We find ourselves in the unenviable position of arguing over what such wonders are worth to us.

This is what the big fight over the Affordable Care Act is all about.

Medical science has gotten into a tangle with economics, the dismal science. And along come the politicians, cracking their knuckles and piling on to make it a schoolyard brawl.

The economist might give you this cold-blooded analysis: medicine is now so much better at doing the thing we always hoped it would do, helping us live longer and better, that it’s become a valuable commodity. The Affordable Care Act seeks to make that commodity more widely available by having society share some of the costs of decent health insurance. The politicians eager to kill the act argue that an unfettered free market would do a more efficient job of distributing the wonders of modern medicine.

A helpful illustration of such unfettering comes from Congressman Bill Huizenga, a Republican representing Michigan’s 2nd District. He tells us that when his son needed treatment for what turned out to be a broken arm he set an example for healthcare consumers everywhere by refusing to take him to the emergency room. Instead he waited until the next day so he could schedule a cheaper office visit.
The good congressman has since tried to put some distance between him and his story. As it happens, making the lad sweat out the night with a broken arm strikes people as cruel. But this is the way the free market is supposed to work. It creates winners and losers, and bugger off to the losers even if they are the most vulnerable among us.

Of course, a person might also conclude that scrapping the Affordable Care Act and throwing 20 million people off their health insurance will have the exact opposite effect of what Congressman Huizenga intends. All these people will land like a tidal wave in expensive emergency rooms because they’ll no longer have the option of calling a doctor. But I digress. The current crop of politicians didn’t come to Washington expecting to put that level of thought into their work.

I am neither economist nor marble-hearted Republican congressman. For me it all comes down to the human lives at stake. People waiting tables. Making hamburgers. Driving cabs. Working farms. Fixing roofs. Remodeling kitchens. Writing songs. You name it. I know one guy who doesn’t work at all and hasn’t since his health crapped out on him. But now he’s on an Obamacare plan and has gotten his knees fixed and his migraines under control. For the first time in years he has a shot at getting his life back.

Which brings us back to the questions I started with. If you think you can put an easy price on life go ahead and be complacent. The free market will take it from there.

The bright ray of sunshine is most of us don’t see it that way. Only a quarter of Americans support repealing the Affordable Care Act. It’s too easy for us to connect the dots and see how it all goes wrong. Healthcare becomes just another part of the wealth that’s getting concentrated in fewer and richer hands. The rest of us end up shut out, just like we’re left watching while the one percenters get the nice real estate and seats with legroom on an airplane. Even worse, it’d be so contrary to American values that we’ll just end up having the fight all over again after the next election. Nothing will be certain but death, taxes and another round of healthcare legislation.

In the old days the medicine show would come to town. A man with a bowler hat and a wagon full of snake oil. It didn’t take long for people to see it for the scam it was. Then out came the tar and feathers.
That’s where we are now. Already the 115th Congress is a medicine show. First it was repeal and replace the Affordable Care Act. Now they’re calling it repeal and delay. Never a word about what might come next. It’s snake oil and everybody knows it. So let’s make things easier for all involved. Make some noise. Let the politicians know Americans may have been caught snoozing by the election, but we’re paying attention now. Maybe we’ll even remember how the tar and feathering thing works, if our new government doesn’t work together and get healthcare right.

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This piece originally appeared on Requiem for Ink, and has been reprinted with permission.

Photo: angela n./Creative Commons