Monday, November 25, 2002

A crisis of common sense. I don't mean to make fun of Diane MacPherson and her family. I'm sure they're nice people. But they've been shockingly irresponsible, and the New York Times wants you to feel sorry for them.

These Lowell residents are the showcase example in today's front-page story on how the health-insurance crisis has reached the middle and even the upper classes. The family is solidly middle-class, and at the moment they are entirely without medical coverage.

How did this happen? By the Times' account, it began when Diane MacPherson lost her job. It would have cost them $931 a month to continue it through the federal COBRA program, so they dropped coverage except for their four-year-old daughter, reducing their monthly cost to $270. Then, when MacPherson's unemployment benefits ran out, they dumped their insurance altogether.

A sad tale, but there's more, much more. It turns out that MacPherson's husband -- he is never named, perhaps because he was too embarrassed to want his identity revealed -- makes $75,000 a year in construction, although the company for which he works offers no health benefits. So there you have it: a family of three, making roughly the median income for a family of four in Massachusetts (for the math-challenged, that means they're making more than the median), has chosen not to pay for health insurance, not for themselves, not for their child.

Continuing coverage just for their daughter would cost just 4.3 percent of their annual gross income, even if Diane doesn't find another job. Yet the Times says MacPherson and her husband simply can't do it, explaining, "Although her husband earns about $75,000 a year, construction work is seasonal and they could not be assured of enough income every month to pay for health insurance." Paging Diane MacPherson and Mr. X! You can set aside more money during the fat months so that you can pay your bills during the lean ones. It's called budgeting.

My wife peered over my shoulder as I was reading this and, photographer that she is, examined the photo of Diane MacPherson and her daughter and said, "Look at the window behind them. They're in a brand-new development!" And, yes, it does appear that they've living large -- way over their heads, no doubt, especially given their new, downsized circumstances. But what this is really about is the misplaced priorities of two adults who ought to know better -- not an insurance "crisis."

Now, if I were a conservative, I would end my little morality tale right there. But I'm not, and I won't. We do need some sort of universal health care to cover the 40 million or so Americans without insurance. Some are poor. Some are sick, and the insurance companies don't want them. Some are small-business owners struggling to keep their heads above water, and the Times documents those cases, too. And yes, some are like our Lowell family, middle-class but with idiotic priorities, putting their dream home and their lifestyle ahead of their health-care needs. The point is that unless you want to live in a Hobbesian state of nature, with everyone on his or her own, we ought to make health care a basic social benefit.

Still, you can't help but cringe when you take a close look at the choices that some people make.

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