So You Can't Afford Mandatory Health Coverage

Now that a watered down version of health care reform is law, I have a prediction that isn't exactly novel: people who abhor anything that sounds like a government mandate will be out in force trying to pick off Democractic congressmen and Senators in the November elections. Just to be fair, there are a number of state and federal mandates that most of us seem to be pretty comfortable with:

All drivers of vehicles must be licensed by a state; drivers of larger and/or commercial vehicles need a special license in most cases. Most states require motorcycle riders to wear a helmet.

Except in a few states, most vehicles on the road require regular inspections based on state standards. If the car doesn't pass, the owner has to fix the problem.

Most states require, at a minimum, that a car owner carry liability insurance in the event of an accident.

With very few exceptions, children are expected to attend school at least through the 8th grade, whether it's through public, private or home schooling.

Blood tests are usually mandatory for couples in order to get a marriage license.

It is mandatory for immigrants to pass a civics test in order to become a citizen of the United States. Many native born Americans would fail it.

It is mandatory for school staff to report suspected child abuse to government authorities.

In many states, a pack of cigarettes is taxed at a rate about 100% higher than they would otherwise be sold - still at a profit to the retailer and supplier.

The common thread? In part it's because we don't want to end up paying for the irresponsibility, unacceptable risk-taking or unluckiness of others. If we are willing, we want to minimize the amount.

I will agree that for some people, the cost of 'mandatory' health insurance will be more than they believe they can afford. They may actually be right. What puzzles me is that some of these people will suffer a catastrophic illness or injury that, if not covered by insurance, I and others will end up paying the bill. This group of people who will refuse to purchase coverage will still expect someone to pay the bill if they can't or will ask for assistance from the government if they can't afford to pay their mortgage bill or rent. They will tell us that it wasn't their fault that they got sick or injured and that it wasn't their fault that they couldn't afford to pay for health insurance. Maybe some of them will be right about that. If that's true, I have no problem subsidizing the insurance purchase through additional taxes. In fact, if a person without health insurance can demonstrate to the government - through a tax return or other means - that they truly cannot afford it, I think the government (meaning us) ought to give the individual a tax credit to cover the amount, even if they have paid no state or federal taxes at all based on their income.

The problem I have is that even when I visit my hometown - hardly a wealthy enclave - I rarely see people driving old cars or cars that get reasonably good gas mileage. I don't know many people who don't have cable television, don't eat out at a restaurant on occasion or don't have a cell phone. Some of these people will be the same ones who say that they cannot afford even the most basic health insurance. That makes me just a little bit angry. I'm not interested in subsidizing people who think they are entitled to a number of luxuries that, taken together, are probably about as expensive as basic health coverage.

I spent a brief period of time - during law school - when I went without health insurance. I drove a car that at least got 40 mpg, didn't have a TV, much less cable. Going out to dinner involved getting a slice or two of pizza. I didn't feel poor but had no one else who depended on me for their own economic security. None of that made me a better person than anyone else but I think I had my priorities reasonably related to my economic reality. I would have jumped at the chance to have health insurance at an affordable rate or a subsidy if I still couldn't pay the entire amount.

That's what this legislation is, in part, trying to fix. Put your political party aside for a minute and think about that.

Governor Patterson's Farewell

When Eliot Spitzer imploded under the weight of his own hubris, the newly sworn Governor Patterson seemed like the perfect foil. His intellect, sense of humor, apparent humility and record in the State Senate restored my hope that New York State would start doing bold, smart, forward-thinking things. It didn't take long to realize that the new Governor's honeymoon could be counted in minutes. He was in a tough position given the economic realities he inherited and lacked the perceived power (or perhaps desire) to push his own agenda. Despite Spitzer's abuse of office in trying to get rid of Joe Bruno - I admired the goal but not the method - Patterson learned very little from it.

Domestic violence may not be the third rail of American politics but I wouldn't mind if it were. If you can't feel safe in your own home, what else matters? If a husband or partner gives a woman a morning gift of a black eye, how do we expect that the victim will have the ability to show up at a march to support more money to find a cure for cancer, volunteer at a hospital or make it to work? Ironically, many women do. They need to feed their families. They apply a little foundation make-up or invent a story to deny the reality. Why do they do this? Many are afraid to report it for a variety of reasons, some of them economic. They also know that the criminal justice system and their elected officials do a terrible job of protecting them when they do report it. For some, orders of protection are useless or come too late. For others, they blame themselves for the violence and don't know where to turn for help. Some churches will continue to tell some of these women that their sacred vows cannot be broken even when their noses change shape every year. Some of them are killed by their abusers.

If it is true that Governor Patterson improperly used his office to interfere with a criminal case involving domestic violence by encouraging the victim to keep quiet or change her story, he should not only lose his job. He should lose his law license and maybe spend some time in jail. It's not just about this case. It's about the entitlement of all victims to a government that is committed to protecting them, however imperfectly. It's about children who should never have to watch a parent sit in an emergency room to get her nose or arm reset only to return to the scene of the crime hours later, wondering when it will happen again and if it will be worse the next time. If you don't believe that it affects kids that much, I can tell you from personal experience that it does.

We imprison people who sell dime bags of marijuana. Fine. We imprison poor people who shoplift food. Not so fine. We usually wait until a domestic abuser violates an order of protection to send them to jail and it's because they are in contempt of Court. Not fine.

I would like to believe that this story, if true, will ensure that our state government will take it seriously, improve the criminal justice system and provide real protection for victims. I don't believe it will, though. My lack of optimism is a practical response to what I have known since I was a kid. Women still lack the political and economic power to stop it. Because the vast majority of domestic violence is between straight couples with females being the typical victims, it could take decades to get it right. Too many women will be injured or killed in the meantime. Maybe women who are not victims of domestic violence could make it their business to organize their husbands or partners to stand up and march to Albany. That might get someone's attention.