At first blush the argument is flush with inspiration for the Obama suspicioners.
We hear it all the time, from the floor of the U.S. House of Representatives to Tea Party rallies to the Rotary Club: This health-care reform is pinned on a mandate, the detractors say.
“Obama’s forcing us to buy something, and that something is health insurance,” the opponents of health-care reform rail on. “And that’s as un-American as, well, things like the president’s name and the State of Hawaii and recycling and dudes buying facial moisturizers.”
When such views are aired, there is much head-bobbing approval and “here-here-ing” among the right’s gasbags.
It’s like with the anti-abortion movement. It sounds utterly Christ-like at a campaign rally at the local pizza parlor to condemn abortion, call for its re-criminalization. But if that position prevails, and abortion is made illegal again, what should the punishment be for a woman who obtains an abortion or a doctor who performs one? How many people are ready to throw the switch on the electric chair on a 17-year-old girl who, after her boyfriend fumbled with the condom placement, opted for an abortion?
The Republican Party these days doesn’t wait to hear the other shoe drop. It’s conservative shot-callers pogo-stick through the legislatures and to the courts with their first gut takes. No pause for reflection, thank you.
We are seeing this play out in the debate over health-care reform.
The question about Obamacare boils down to this: If it is so evil and awful for government to require people to buy health insurance, then isn’t it logical to similarly hold that it is evil and awful, and quite French of us to boot, to force hospitals to provide treatment to people without insurance as we have for years?
This is exactly how U.S. Sen. Tom Harkin, D-Iowa, is framing the health-care debate. It’s a powerful argument because it takes the conservative opposition to health-care reform to its logical conclusion: people bleeding to death on emergency-room floors in an America where health care is purely transactional, 100 percent capitalism, an exchange between buyer and seller no different than what happens at Walmart or the Chicago Board of Trade.
Under the Emergency Medical Treatment and Active Labor Act, hospitals can’t say to an uninsured person with a gunshot wound or heart trauma, “’Well, get out on the street and die,’” Harkin said.
Said people will get health care, at the most expensive point, with no requirement that they ever pay for it. These scenarios, as Harkin points out, are covered by those who do have insurance through higher rates.
How about that mandate? Harkin asks.
Of course we could scrub American health care of all mandates.
“Do Republicans and others who want to repeal this law, do they want to just say that, ‘No, when people show up to the emergency room, if they don’t have health insurance, they cannot get health care no matter what their situation, no matter if they’re a child that needs emergency care, an elderly person — no matter who,’” Harkin said in response to questions on this during a conference call with The Daily Times Herald and other media. “’If you don’t have health insurance you can’t get care.’ Is there anyone that heartless in our society to say that?”
Harkin expects the fate of the health-care-reform package passed in the last Congress to be decided in the courts.
“It obviously will make its way to the Supreme Court,” Harkin said.
He added, “How that’s going to go, I have no idea.”
At issue is the so-called “individual mandate” which, according to a thorough description by The Washington Post’s Ezra Klein, will require people who don’t have health insurance and make enough so that a policy is not more than 8 percent of their monthly incomes to buy it.
Making people “buy something” isn’t what the government should be doing, say the forces massed to take down the 2010 health reform.
But shouldn’t the Republican state attorneys general and leading conservatives making this case account for the other shoe dropping?
As this proceeds in the courts, both real and of public opinion, is there any way to detour the billion-dollar question: If government can’t be required to make people pay for health care, then how can it ask doctors and nurses to give away what they otherwise sell through the mandate on emergency care?
“I’m going to be making that argument,” Harkin said. “I’m going to be saying, ‘Look, OK, then we should take away any mandate to any hospital. It does not have to provide emergency care to anyone who walks in there’ and let’s see how heartless people are.”
Because of that care mandate, Harkin notes, those Americans who do have health insurance pay more.
“There’s a mandate right now that each of us has to pay more in health insurance to cover those who are uninsured and go to the emergency room,” Harkin said. “That’s a fact of life. That’s a demonstrable fact.”