Opponents of the health insurance mandate–and of ObamaCare in general–ask the question: If the government can force you to buy health insurance, then why can’t it force you to buy broccoli? After all, broccoli is good for your health too. Their argument appears to be that mandating the purchase of health insurance is a slippery slope that will lead to the federal government stomping on both our personal freedom and our Constitutional right not to eat broccoli.
This is the kind of debate I love. Maximum silliness. Not being an attorney, I can’t speak to the legal validity of the broccoli argument or to the broader discussion concerning interstate commerce and Congress’s authority to regulate it. But I do have some issues with the broccoli example. Here are five:
1. There are lots of substitutes for broccoli. You can buy kale or escarole or any number of other green vegetables. There really aren’t any substitutes for health insurance besides unlimited wealth, Medicaid (if you’re poor), Medicare (if you’re old) or becoming a citizen of a nation with universal healthcare.
2. I’m guessing a government mandate to purchase broccoli would raise the price of broccoli at least in the short-term. Even if supply eventually caught up with demand, I’m guessing the price of other green veggies would likely rise as farmers devote more acreage to growing broccoli. (I’m from the Bronx, so if any readers out there actually know something about growing stuff, feel free to chime in). In contrast, a government mandate to purchase health insurance will lower the price of health insurance by bringing more healthy people into the risk pool. As the state of Massachusetts notes in its Supreme Court brief supporting the mandate: “Massachusetts now finds that its efforts to stop healthy people from opting out of purchasing health insurance have increased health-plan enrollment and helped decrease the rate of premium growth.”
3. Just because you buy broccoli that doesn’t mean you’re going to eat it. Ask any kid. That suggests the benefits of a broccoli mandate aren’t concrete. Furthermore, while healthy foods–and wellness in general–are very good things because they increase our longevity and quality of life, their impact on healthcare costs is less clear. For example, evidence suggests that longer life means living with more medical conditions that require more treatment. It would appear that you have to pay the piper at some point. In contrast, the benefits of a health insurance mandate are very clear: a broader risk pool and lower premiums.
4. People who don’t eat broccoli (and I’m speculating here) typically don’t find themselves in acute need of broccoli, causing them to race to a 24-hour emergency broccoli kitchen where they receive broccoli at no charge–the cost of which is passed along to other broccoli eaters. In the case of the uninsured, that’s exactly what happens. HHS quotes data suggesting uncompensated care adds $1000 to a typical family’s annual healthcare premiums. Only the really wealthy without health insurance have a legitimate beef–assuming they actually pay for their care out-of-pocket.
5. It’s not exactly clear to me why mandating the purchase of health insurance is all that different from other government mandates: auto insurance, payroll deductions for Medicare and unemployment insurance, or ensuring kids get a proper education. Furthermore, we’ve been able to mandate things like the wearing of seatbelts, for example, without going down the slippery slope of requiring crash helmets and flame-retardant suits for all drivers.
Maybe the best argument I’ve heard against the mandate is that it’s a cop-out. To wit: Democrats didn’t have the political will to push for single-payer healthcare (e.g., Medicare for all) so they created this Frankenstein monster of a law known as ObamaCare based on RomneyCare that utilizes an unconstitutional concept–the mandate–invented by the very conservatives who now oppose it.
No matter how the Supreme Court decides, one thing remains unchanged: there’s only one way I eat broccoli–blanched, chopped and mixed with pulverized anchovies, olive oil and Romano cheese over ziti. Yum!