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How Many Supreme Court Justices Can Dance on the Head of a Pin?

As we head toward summer, the Supreme Court considers the fate of tens of millions of Americans with pre-existing medical conditions. SCOTUS has placed great emphasis on this question–If the US government can mandate that individuals buy health insurance, then why can’t Uncle Sam force us to buy broccoli too? To put this erudite question more plainly, how is the purchase of health insurance different from the purchase of broccoli?

Hospital Hallway photographed by Adrian Boliston.

First, let us acknowledge that SCOTUS (or at least four or five of these guys) may have gotten themselves in over their heads. As judges, they’ve been pulling in six figures a year on the government payroll. I suspect their entire experience with the purchase of health insurance is checking off a box on a form each year. They get handed one of those nifty plastic cards (maybe it’s even platinum with an eagle on it, them being SCOTUS and all), and then we, the taxpayers, pick up the tab whenever they go to the doctor.

For the rest of us, it’s not quite that simple. As someone who is self-employed, low-income, and over fifty, I have a whole lot of experience in purchasing health insurance. And I have also bought a helluva lot of broccoli. Allow me to explain the difference between the two.

A head of broccoli may be purchased at Safeway, Lucky’s, Food Max, Trader Joe’s, or the framers’ market for anywhere from 99 cents to $1.69 a pound or a bunch, depending upon whether or not it’s on sale. You can be 15 years old or 95 years old, and you will pay the same price.

Health insurance, on the other hand, must’ve been dreamed up by a scam artist. It is one of the most deftly manipulated confidence schemes there ever was. When you’re in your twenties, you may find it affordable (depending on your circumstances). When you’re in your thirties, the premiums will start to pinch your monthly budget. In your forties, those premium hikes will squeeze you enough so that health insurance will be your biggest budget item after housing costs. But once you cross the big five-zero, that’s it. My husband and I paid for our own health care from our early twenties until just past the age of fifty. The premiums skyrocketed to over $500 per month for a policy that would’ve required us to pay $10,000 out of our own pockets before the “insurance” started to cover anything. And then, even after the so-called insurance kicked in, it covered zero in prescriptions.

So, after more than 25 years of paying our premiums on time every month (in addition to out-of-pocket expenses, deductibles, and co-pays), we were forced off the rolls.

The good news is that we can still buy as much broccoli as we want and anywhere we want to. And if we’re not in the mood for broccoli, we can dine on brussel sprouts, asparagus, or cauliflower–the sky’s the limit.

Now, if your health insurance company has doubled or tripled your rates, because you’ve turned 50, go ahead and shop around to see who’s willing to insure you. And good luck!

Another way of phrasing it so that those august members of SCOTUS may understand it better–no one needs to mandate to farmers or grocery stores that they must sell broccoli to anyone wishing to buy it. The farmers and grocers are willing and eager to do it.

Unfortunately, it has become necessary to mandate to insurance companies that they must sell insurance to everyone seeking it. And yes, your honors, that is one more way in which health insurance and broccoli are not too much alike. The consequences of not buying one can be pretty damn serious while the consequences of not buying the other are trivial.

And this, of course, brings us to the subject of free-loaders. While some members of SCOTUS and rich folks like Ann Coulter see uninsured people like me as free-loaders, I see the free-loaders as the health insurance industry, which has pocketed my money over 25 years. In other words, we invested thousands of dollars in the purchase of insurance, so that we could have access to health care. They accepted our money month after month for over 25 years, knowing full well that they would pull the rug out from under us just as we would become more likely to use the money we’d invested.

I confess that I don’t have a legal background, so I don’t know how to make it more plain than this to nine of the best legal minds in the country–there’s a pretty damn big difference between buying broccoli and buying health insurance. If the esteemed gentleman serving on that august body will bear with me for a moment–how about this? Just think of it, your honors, as The Triple C: Cash, Choices, and Consequences. The next time you’re comparing broccoli to health insurance, ask yourselves these questions. How much cash does it take to purchase it? How much choice does the buyer have in where, when, and whom to purchase it from? And, finally, if the seller refuses to sell it, how serious are the consequences of not being able to buy it?

As SCOTUS reviews the individual mandate and decides whether to uphold it, strike it, sever it from the ACA, uphold or strike down the entire law; I hope your honors will ponder questions other than the difference between broccoli and health insurance. May I respectfully suggest a few questions that would make better use of your intellectual gifts:

First, how many uninsured people will be squeezed into hospital emergency rooms who could’ve been seen instead in doctors’s offices? And how much will that cost us?

Second, how many more years will this country endure health care chaos if the entire ACA is struck down? After Bill Clinton failed to pass health care reform, 15 years of inaction followed before another attempt was made. (I would love to share Robert Reich’s view that this would pave the way for single-payer or Medicare for all. But I am more pessimistic. Obama and most Democrats are not bold risk takers. If the entire ACA is struck down, they will run and hide. The subject of health care will become so radioactive that no one will touch it for another fifteen years.)

Third, how much respect is SCOTUS willing to sacrifice to strike down the ACA? Justice Thomas’s wife has earned six figures in speaking fees from groups opposing health care reform, but he has not recused himself.

Fourth, how many different ways and how far can the commerce clause be stretched? SCOTUS has ruled that the commerce clause gives the US government the authority to over-rule states that have legalized medical marijuana. Suddenly this same federal authority over states can evaporate if the issue is health insurance? Really?

Fifth, how many more Americans will have to die before access to health care is recognized as a basic human right? 45,000 Americans die each year, because they lack insurance (Harvard study published 9-17-09).

So, your honors, the country respectfully awaits your brilliant erudition on whether the individual mandate is constitutional. But whatever you rule, please do not insult our intelligence by telling us the purchase of health insurance is the same as the purchase of broccoli. Every year, 45,000 Americans and their families learn that it is not.

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Janet Rhodes

Janet Rhodes