Justice Sandra Day O'Connor -- "I'm Uninsured"
When Did Un-Insuring All of Us Become Big and Beautiful?
Justice O’Connor — “I Don’t Have Health Insurance”
Shortly after Justice O’Connor retired from the Supreme Court, I found myself sitting next to her on a stage at a policy conference in Washington. My topic was tax reform. Hers was healthcare.
“Healthcare? Why is Justice O’Connor discussing healthcare? Why isn’t she discussing constitutional law or the role of the courts or something connected to her career?”
But we were meeting at a time — pre Obamacare and pre expansion of Medicaid — when 50 million Americans had no health insurance.
I listened to her speak, eloquently and from the heart. She spoke of the need for universal healthcare, i.e., universal health insurance.
“Why,” she asked, “can’t a nation as rich as ours provide this basic necessity to all its citizens?”
I approached her during the coffee break.
“Justice O’Connor, it’s an honor to meet you. I appreciate and agree with your comments. But may I ask you a personal question. Is a member of your family uninsured?”
She looked at me for a long time and then responded.
“Yes, my grandson. He has a pre-existing condition. As a result, my son can’t purchase health insurance for his family.”
“I understand. This means you are uninsured. Am I right?”
“Yes. I don’t have health insurance. Of course, my husband and I are covered. But we’re responsible for my son and his entire family, especially for major costs.”
My reply:
“I thought this likely. We’re all uninsured. But most people don’t realize it.”
I’ve never told anyone about this conversation. But I’m sure Justice O’Connor, who passed in 2023, would, given the One, Big, Beautiful budget (BBB) bill, permit my making it public.
Getting Screamed At at The Country Club
The Country Club in Brookline, MA is the oldest golf club in the country. Founded in 1882, The Club was where the Lowells spoke to the Cabots and the Cabots spoke to God.
You’re surely familiar with the Cabots and the Lowells. Recall the old ditty: “Here’s to the town of Boston, The land of the bean and the cod, where the Lowells speak only to the Cabots, And the Cabots speak only to God.”
The Club’s blood ran pure blue for almost a century. That’s when they opened their doors to the muggles — first Jews, then women, and, finally, blacks. I was aware of this history when I was invited, in 2007, to speak about my then new book, The Healthcare Fix.
The book calls for Medicare for All, but the Republican version — AdvantageCare, not traditional Medicare. Under AdvantageCare, healthcare providers receive a voucher from the government based on their enrollees’ pre-existing conditions and then compete for enrollment. It’s far from perfect, but it’s attracted over half of Medicare participants with the share choosing AdvantageCare growing every year.
The updated version of the plan — The Better Care Plan, which I co-authored with a Who’s Who of healthcare experts, including George Halvorson, former Chairman and CEO of Kaiser Permanente, is our only path to national fiscal solvency and personal financial security. Yet, its simple, 10 bullet-point, healthcare fix isn’t part of the 887-page BBB.
The Club’s dinning room was what I expected. Lots of trophies, pictures of golf tournaments, dark wooden panels, and roughly 35 pale faces — all male and all 55+. After the entree, it was time to sing for my supper. I was graciously introduced, mentioned my thesis, and pointed out that one in six Americans were uninsured.
Immediately, two members leapt out of their chairs and started screaming! I was stunned. For a moment I thought I was at a family holiday dinner where such behavior was de rigueur, indeed, mandatory.
What were these two well dressed, older WASPs thinking? I had never stepped foot in The Club, but I knew that screaming at The Club’s dinner speaker wasn’t, how should I put it? Kosher.
They took turns.
“Why should I pay for anyone else’s healthcare?”
“Let them buy their own health insurance.”
“We don’t need more socialized medicine.”
“I can’t believe you graduated Harvard.”
My host turned green.
Mercifully, dessert arrived forcing my verbal assailants to choose between running or feeding their mouths. They were heading back to their chairs when I seized the moment.
“Let me ask you two questions.
First, what are your professions?”
Both said they were physicians.
My jaw dropped. Two rich doctors, with well developed potbellies, vehemently opposed to universal health insurance. Why?
The answer was obvious. They were worried they’d have to pay higher taxes to help defray the costs of better healthcare for the poor. Yet, the Better Care Plan is designed to lower, not raise taxes by emulating other advanced countries’ healthcare systems — countries spending 6 percent less of GDP on healthcare with dramatically better outcomes.
Question 2.
“Does either of you have a relative without health insurance?”
Silence followed by white faces turning red.
Finally, one admitted to having an uninsured younger brother. This led the other to disclosing his uninsured niece.
“Why can’t they get health insurance?”
They then described their relatives’ pre-existing conditions, with prospects of very high future healthcare expenses.
“You realize you are uninsured?”
Even longer silence followed by two versions of:
“I see your point. I apologize for interrupting.”
An Obamacare Taxi Tirade
It’s 2013. I’m in a taxi heading to Dallas from the airport. The driver is her sixties— a nice lady who loved to talk. Within a few minutes, I knew her life story as well as her absolute hatred of the government, Democrats, President Obama, and Obamacare. I held off asking for the ranking.
Having established her fundamentals, she moved onto her son and his myriad health problems.
“Thank God for his health plan.”
“Does he have health insurance at work?” I asked.
“No. He’s a self-employed handyman.”
“What’s his health plan?”
“No idea. But it’s a real good one. Even comes with a subsidy.”
“I think he’s on Obamacare,” I said.
“Don’t tell me that.”
“Yes, I’m sorry,” I replied. “But any private company would charge half his salary. He surely didn’t have health insurance before Obamacare.”
The rest of the trip was very quiet.
The Big, Beautiful, Budget Bill Cut Everyone’s Insurance
The BBB directly eliminates health insurance for an estimated 17 million Americans. This will raise the total number of formally uninsured Americans to roughly 45 million. That’s close to the pre-Obamacare total.
What about effectively uninsured Americans? That’s all of us with the exception of the super rich who take care of their own in our Divided States of America.
So, if you are a typical middle- or even upper-income member of Congress who voted for the BBB, let me put you on notice. Your vote will come back to haunt you, financially and emotionally.
How, what, when?
When your uninsured godson ends up facing a $100K bill for a vital operation that neither he nor your sister can remotely afford.
But not to worry. Self insure. Cut out your next ten vacations and you’ll be all set. Oh, you have a goddaughter too? Well, bartend on weekends? And do schedule a talk at The Club. You’ll get a warm reception.
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Many of the physicians that treated me over the years were foreign-born or trained overseas. They were all hard-eyes business men, as focused on the business end of medicine as on the medical profession itself. I recall reading an interview with a professional woman in America who had no clue about dating. Her aunties back home in India convinced her to let them find a husband for her. Her one request to them: that he be 'a good man? faithful? kind' - nope. "Please, please, please make sure he's a doctor!" Nuff said.
Much as I appreciate your knowledge and perspectives, I wish you would use the modest influence you have to decry the reprehensible slaughter through starvation going on in Gaza. Me thinks you are majoring on minors and minoring on majors. I wish I didn't feel compelled to say this and quite honestly don't know how I would act where I in your shoes, but...