Point Austin: It's About Community

Health care a matter of equity and common humanity

Barack Obama in Austin in 2007
Barack Obama in Austin in 2007 (Photo by Gary Miller)

If you're collecting absurd reactions to last week's Supreme Court decision on the federal Affordable Care Act – aka Obama­care – you could start with Texas Attorney General Greg Abbott, who initially announced that the court had ruled the individual mandate unconstitutional. "The decision marks a turning point in constitutional history," wrote Abbott. "The Supreme Court rebuked a runaway federal government that tried to hijack the Con­stitution by imposing an unprecedented requirement forcing Americans to buy a product against their will." Abbott apparently derived his initial press release from premature TV reports that the mandate had been struck down – rushed reports that the embarrassed networks later had to retract.

As did Abbott, an hour after his initial release, although his "updated" statement did not acknowledge any mistake – just cannibalized the first release to make himself sound like Pee-wee Herman after a pratfall: "I meant to do that." In the updated release, the decision was no longer "a turning point in constitutional history"; it had mysteriously diminished to a "rebuke" to "an overreaching federal government." One expects an occasional deadline stumble from reporters trying to beat the competition, but shouldn't an attorney general (or his staff) – particularly one who sued to block a federal law – have actually read the court's decision before he attempts to describe its contents?

Kinda makes you wonder how Abbott would score on a STAAR test for professional accountability.

Gov. Rick Perry at least waited until his staff told him what had actually happened, although his reaction was equally predictable. "This ruling will be a stomach punch to the American economy," Perry thundered. "It is a shocking disappointment to freedom-loving Americans desperate to get our country back on track. ... Freedom was frontally attacked by passage of this monstrosity – and the Court utterly failed in its duty to uphold the constitutional limits placed on Washington." Let it never be said that the governor of Texas cannot compound inaccuracy with hyperbole; it's what made him such a great presidential candidate.

Free To Suffer

It's certainly entertaining to see the kind of apoplexy GOP officials have been reduced to in the wake of the court's decision. You wouldn't think such hysteria would be the "conservative" response to an incremental, private insurance-based solution to the country's health care predicament, a solution invented by conservative think-tanks and sponsored by a moderately liberal Democratic president. Perry in particular should welcome federal assistance to Texans, roughly 25% of whom live without health insurance altogether – relying instead on emergency care (or none) to protect their families.

Among the many folks who offered a more rational response to the court's decision, Houston state Sen. Rodney Ellis noted that the law is "not perfect," but has already made life better for millions of Americans. "Today, millions of women get preventive services like mammograms and pap smears without a co-pay," Ellis wrote. "Health plans must now spend 80 to 85 percent of every premium dollar on health care, insurers can no longer deny coverage to children with pre-existing conditions, young adults can be covered under their parents' plan until 26 years, and tax credits are available to small businesses to help cover premium costs. More than 120 of Texas' largest employers have received over $445 million in federal support to make early retiree health coverage more affordable. In addition, 2.2 million Texas seniors in Medicare received preventive services or check-ups with no co-pay, and Texans saved $135 million on prescription drugs as a result of closing the Medicare prescription drug 'donut hole.' The greatest gains will come in 2014, when approximately 2 million more uninsured Texans will gain coverage through Medicaid and CHIP."

Of course, the "freedom" to do without health care is not an entitlement the governor nor his allies will ever have to exercise. Yet Perry and the Republicans have already vowed to block not only the ACA, but any expansion of Medicaid in Texas. What caricature of "freedom" enables public officials to deny basic services to the people most in need of them, while they themselves are completely insulated from such risks?

A Reason To Celebrate

For the moment, I'm not much interested in the partisan debate now ensuing over whether the ACA mandate constitutes a "penalty" or a "tax," a distinction of major significance only to those who, because they already have insurance, won't have to pay it. As we all share common responsibility for the maintenance of public health resources – our local property taxes pay for all that emergency care our feckless state officials make necessary by omission – it only stands to reason that we all must share the risk, exactly as we share fire and police expenses instead of the ludicrous alternative of paying for them on demand. More fundamentally, the human right to basic health care – to life – is as inalienable as the "life, liberty, and the pursuit of happiness" enshrined in the Declaration of Indepen­dence that we are duly celebrating this very week.

In the name of our common humanity, and our democratic community: Happy birthday, U.S.A.

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Affordable Care Act, health care, Barack Obama, Obamacare, Greg Abbott, Supreme Court, Rick Perry

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