OP-ED

Why do the uninsured want to stay uninsured? They won’t say

Picture 3 Two uninsured people who insist on their right to remain uninsured have joined 20 states and the National Federation of Independent Business in suing to overturn the new federal law requiring all Americans to obtain health insurance or else pay a tax penalty.

The lawsuit, filed in U.S. District Court in Pensacola, Fla., claims the government is exceeding its constitutional authority to regulate interstate commerce.

The states added the two individuals as plaintiffs because the government is likely to argue that the states lack legal standing to challenge the individual insurance mandate, given that it only affects individuals, not the states.

But the public can’t find out why the two new individual plaintiffs — an auto repair shop owner in Panama City, Fla. and a retired lawyer/Wall Street banker living in Port Angeles, Wa. – oppose the insurance requirement because the lawyer spearheading the suit says they aren’t speaking to the news media.

I particularly wanted to know how these two uninsured people have paid for health care for themselves and their families in the past and how they plan to pay for it in the future. So I asked David Rivkin, a partner at Baker Hostetler in Washington, D.C., who is representing them and the NFIB and serves as outside counsel for the states, if he could put me in touch with them.

“They aren’t public persons and don’t want to give up their privacy,” said Rivkin. He did say they are both around 50 years old – an age when most Americans are anxious to have good health insurance. That made me even more curious about their motives for joining the suit. I also found it funny that two people jumping into one of the country’s biggest political controversies expect to maintain their privacy.

Rivkin’s privacy claim may or may not be true for Mary Brown, the repair shop owner. She initially told me in a brief conversation that the attorneys didn’t want her to talk to the media. Then, after calling Rivkin’s office, she called back and said she’s so busy with her business that she doesn’t have time to talk to reporters. She very courteously indicated she actually would like to talk to me, perhaps at a later date.

But the assertion of privacy doesn’t seem to fit Kaj Ahlburg, a Harvard University law graduate and Clallam County Republican Party leader who recently was appointed to the Harbor-Works Development Authority board in Port Angeles.

Described by Rivkin as a “person of means,” Ahlburg is no shrinking violet. He’s often quoted in the local press commenting on controversial issues such as the U.S. Supreme Court’s eminent domain ruling in Kelo v. New London. And he recently has given public talks on the Islamic religion and on al Qaeda. In December, he spoke to a county GOP gathering on how to mitigate the threat of electromagnetic pulses caused by nuclear explosions high above the atmosphere. Hmm, who knew?

According to an announcement advertising Ahlburg’s January 2009 al Qaeda speech at the Bremerton-Olympic Peninsula Navy League, Ahlburg practiced law and investment banking for 19 years in New York City, is a member of the International Assn. for Counterterrorism and Security Professionals, and watched the Sept. 11 attacks from his office window in Manhattan.

Still, the normally outspoken Ahlburg did not return my two calls to his home.

Based on his background and interests, Ahlburg is obviously a man who values liberty. But he apparently has the financial means to maintain his freedom from health insurance. “He’s been paying his own way any time he incurs medical expenses,” Rivkin said. “He’s done that for years. His health care footprint is zero, and he has no desire to buy health insurance.”

Brown must be an even more freedom-loving person, because she does not seem to have the resources to pay for costly medical care out of pocket.

According to NFIB spokeswoman Melissa Sharp, Brown has co-owned the Brown & Dockery auto repair shop for four years and is “struggling to keep the doors open.” She does not have health insurance for herself and doesn’t provide it to her two employees. Brown has two daughters and two step-daughters; Sharp said she didn’t know the ages of Brown’s children or whether they have any health coverage.

“She’s adamantly opposed to the government telling her she has to buy coverage,” Sharp said.

Rivkin said, “I wouldn’t care to speculate about what she’d do if she became ill. That’s how she chooses to lead her life. There are certainly people who believe that given their current circumstances and health, it is prudent for them to defer getting coverage until some point in time in the future.”

When I asked Brown herself how she pays for health care for herself and her children, she said she gave all that information to the Baker Hostetler lawyers and that I should ask them.

While Rivkin argues that Brown’s and Ahlburg’s personal circumstances are irrelevant to the legal case, Washington & Lee University law professor Timothy Jost says those facts eventually will be highly relevant. “The judge will certainly want to know a lot more about their circumstances,” said Jost, who has written extensively about health reform.

But, he said, the individual plaintiffs’ personal circumstances will only matter in 2015, when the tax penalty applies to those who don’t obtain health insurance. Until then, he said, the lawsuit is not ripe because there is no actual injury. Thus, the courts lack jurisdiction. He predicts the courts will toss the case on that basis.

Of course, by 2015 Brown and Ahlburg may have changed their minds and gotten health coverage. After all, under the new reform law, insurers won’t be able to turn away people in their 50s with preexisting conditions, and there will be sizable subsidies for small business owners like Brown. If that happens, then the states and the NFIB would have to look for some new plaintiffs who demand freedom from health insurance.

Harris
Meyer is a journalist based in Yakima, Wash., and winner of the Gerald Loeb
Award.  He has over 27 years of reporting experience for law and health
care publications, alternative newsweeklies and television news.

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Down with Greedy Bastard DoctorsSundyAnonymousPeterVikram C Recent comment authors
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Down with Greedy Bastard Doctors
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Down with Greedy Bastard Doctors

Mr. MD as Hell goes against every single goddamed and forlorn thing that he’s supposedly sworn to uphold in the Hippocratic-now-Hypocritcal oath: “I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as… Read more »

Sundy
Guest

PAY IT FORWARD. I’m a health insurance agent that meets people everyday that can’t get insurance because of pre-existing conditions or lack of money. I also meet seniors in the “doughnut hole” of their Medicare Part D. There’s a community service project to I sponosr to help people pay for their medicaitons. Go to http://www.helpinglives.net to print your own discount prescription drug card. Use this card on all your prescriptions. There is no expiration date and no limit on the usage. Save between 10-60%. It works at over 60,000 participating pharmacies like Wal-Mart, Walgreens and CVS.

Peter
Guest
Peter

“SS and Medicare are nothing more that Ponzi schemes.”
They’re paying off pretty well for ponzi schemes. Isn’t the entire world economy (especially private health insurance) a ponzi scheme, music stops payouts stop.

MD as HELL
Guest
MD as HELL

Peter,
Are you a Madoff knock-off? SS and Medicare are nothing more that Ponzi schemes. When the music stpos…see if there is a chair left.

Margalit Gur-Arie
Guest

Thanks, MD. Unfortunately, I don’t have any good answers, but I strongly believe that if everybody stepped off their little soap boxes (including me sometimes), and particularly in Washington, we could reach an optimal solution.

MD as HELL
Guest
MD as HELL

Margalit, Breast cancer and heart events were always considered major medical events. There used to be very affordable insurance for major medical, back when prices were reasonable. Today’s discussion has been about a monolithic bureaucratic healthcare bill and system that is to cover everyone for anything their hearts desire. That is impossible to administer and to afford. As for access for breast cancer and heart disease, there needs to be a risk reward consideration in everything an adult chooses to do. If they choose to build their house with straw or twigs, then they might get blown away. Whose fault… Read more »

Peter
Guest
Peter

“We are force to pay a tax for SS and Medicare, but their is nothing in it for young people when they pay in.”
Why, because young people can’t see past today when deciding what to spend on what they can enjoy NOW. But I agree because young people, and everybody, should have access to the same system, regardless of their financial resources and age. The solution is not to force everyone to pay into a grossly out-of-control profitable system, but to bring down costs so that the payment burden is a low as reasonably possible.

Margalit Gur-Arie
Guest

MD as HELL, I respect you enough to know that we can have this conversation on a different level.
How about the 40 years old with breast cancer, or the 50 year old with heart disease, or a very premature baby….. ?

Bart
Guest

ATTEMPT REALITY ” .. We are perfectly fine with some people having less house, less car and even less food, but are we OK with some people having less life?” The USA is the only country where “poor” people die prematurely from heart attacks due mostly from over-eating, smoking, dope, booze, NASCAR-like living, and watching too much TV and doing nothing else. “Poverty,” indeed! Not to mention the illegal immigrants who have 4+ anchor-babies. You really think OWE-bama’s claim that illegal immigrants won’t be treated is real? Sure — and Bernie Madoff is innocent. Heck — even France has started… Read more »

Bart
Guest

ASKED, ANSWERED
“Why shouldn’t we be free to say “No, you’ve got to contribute as well.”
Not when inexperienced INCOMPETENTS are in charge, Mr. Democrat. That’s on y-o-u, sir.
Fight your INCOMPETENT masters, to the end. See you and your pal Barack in court.

MD as HELL
Guest
MD as HELL

Deform creates a monolithic bureaucracy that will consume tons of resources before the first doctor visit ever occurs. Why should anyone be forced to support it? People will always die. People should live the life they have been given while they are healthy. When health is lost, no amount of money really restores it. What is the value to a 27 year old of a 90 year old maintained on dialysis? If the family of a 90 year old had to spend the value of the ranch on the care of the 90 year old there would be a different… Read more »

Margalit Gur-Arie
Guest

MD as HELL, Here’s my problem with the house/car analogy. If I am the CEO of Cigna, I buy this big 12 room mansion in a gated community and pay my mortgage. If I am the receptionist at Cigna, I buy a little condo in the city and pay my very different mortgage as best I can. Maybe later, when I get a promotion I buy a ranch house a couple of hours away from the city. Both as CEO and as receptionist, I can lead a happy useful life. When it comes to large health care expenses, there is… Read more »

MD as HELL
Guest
MD as HELL

Margalit, I am an ED physician. I already am working for far less than half of my charges. My biggest thief is the US government. My hospital sees everyone. People would have enough money for healthcare if the feds had not wrecked the price list in the 1980’s. An office visit in 1979 was 12 dollars. Thanks to government and third party payors the rice ramped up to today’s unbelievable and unaffordable levels. But people don’t need cash for care. People don’t have cash for a car either, but they buy them all the time. They pay for them over… Read more »

Margalit Gur-Arie
Guest

MD as HELL, are you suggesting that health care taxes should be levied by the States instead of the Feds, or are you suggesting that physicians should be compelled to work for free? I understand that you personally will not let someone die in front of your eyes, if you could help it, but most physicians and hospitals will refuse to see a patient without money or with too little money. Are you accepting Medicaid? Will you accept Medicare if the cuts go into effect? Do you see charity as the solution, and by charity I don’t mean tax payer… Read more »

Harris Meyer
Guest
Harris Meyer

People don’t need health insurance to pay for health care??? Not even catastrophic coverage? How about bartering chickens for health care? You think the Mary Browns of the U.S. (read most Americans)have the means to pay out of pocket for medical care for serious illnesses or injuries to the tune of tens of thousands of dollars? I sure don’t know such people among my middle-class friends, relatives, and acquaintances. MD as Hell is still dodging the essential contradiction in his opposition to mandated health coverage. Someone is going to pay for that costly care for the uninsured, and that someone… Read more »