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Pittsburgh Tribune-Review: “Life, death & choices”

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In my column for the February 12th, 2010, edition of the Pittsburgh Tribune-Review I unspun a story spun by the Obama administration to drum up support for Obamacare [2]. You can read my column beneath the fold.

Life, death & choices

President Obama recently brought the health care debate, as they say, “down to the human level.” Here’s how The New York Times described the event: “For a moment, President Obama’s pledge to keep fighting for major health care legislation got personal on (Feb. 4) as he told supporters at a fund-raiser about a former campaign worker in St. Louis without health insurance who had died of breast cancer. ‘She insisted she is going to be buried in an Obama T-shirt,’ he said …. ‘How can I say to her, ‘You know what, we’re giving up’?”

Most of the commentary about the president’s remark centered on the somewhat macabre picture of this poor woman being buried in an Obama T-shirt — and Mr. Obama thinking it to be appropriate to reveal to his audience her dying wish. (Turns out that the woman wanted to be cremated, not buried, while wearing an Obama T-shirt. But I digress.)

Let’s look at some non-burial-garment facts about the woman in question.

Her name was Melanie Shouse. She was 41 years old when she died on Jan. 30. She and her boyfriend owned a small business that they started 12 years ago, Sweet Meat Stix.

She was also politically active in modern left-of-center causes. One of her activities was volunteering to work for Barack Obama’s presidential campaign in 2008.

The president, however, was mistaken when he said that she died without health insurance. Ms. Shouse, in fact, had health insurance — catastrophic-coverage insurance, to be precise. With lower premiums than conventional health insurance, catastrophic-coverage policies kick in only when annual medical bills become high — in Shouse’s case, $5,000.

According to Shouse’s own account, when she discovered a lump in her breast, she didn’t go to a physician for treatments because she couldn’t afford the out-of-pocket expense of such treatments.

The president’s narrative is that, if government had been more active in supplying or regulating health insurance, Shouse could have afforded insurance (or insurance without such a large deductible). Not having to pay so much out of pocket to visit a physician, Shouse would therefore have gone to the doctor as soon as she detected the lump. With earlier diagnosis and treatment, Shouse might well still be alive.

In short, the story goes, Shouse was failed by a dysfunctional health care system.

But this story is all wrong. Shouse wasn’t failed by a dysfunctional system. Shouse failed herself. She chose to put herself in the position that led to her death.

To many ears, the previous sentence sounds harsh. Is it? I don’t think so.

First, Shouse’s decision not to get immediate medical treatment was a risk that she obviously believed to be worth taking. Every day, many people knowingly take risks in return for rewards that seem to them to be worthwhile. Shouse’s decision not to seek immediate medical care is no more incorrect than is the decision of, say, someone to take a job as a high-rise construction worker. Both decisions are risky, but both increase the amount of money the person has on hand to spend on things such as housing, clothing and entertainment.

Second, it’s not believable that Shouse couldn’t afford to visit a physician. The owner of a business successful enough to have lasted for 12 years is unlikely to be destitute.

Again, Shouse had time to volunteer to work for Mr. Obama’s presidential campaign. This is time that she instead could have spent working at a job that paid her extra income. It’s quite possible that the amount of income that Shouse could have earned by working those hours rather than by contributing them free of charge to Obama’s campaign would have been enough to pay her high-deductible medical expenses.

Third, she chose to buy a catastrophic-coverage policy. Surely she knew — or ought to have known — that each year there’s a good chance that she will require routine (that is, non-catastrophic) medical care. Could she not have saved a small sum of money each year to cover this obvious likelihood?

Remember, the most that Shouse would have had to pay each year is $5,000. This is no small sum, but it’s hardly an amount that is out of reach of the typical American.

Think of yourself: If you learn that you’ll likely die unless you spend up to $5,000 over the course of a year on medical care, would you be able to find the money?

It’s true; coming up with that kind of money for medical care entails sacrifice. But that’s reality. If Shouse was unable to spend $5,000 of her own money to save her own life, what right has she — or Obama — to expect other people to spend their money to save her life?

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