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Health Care Reform with a Heart:
How to Answer the Bleeding Hearts
By Craig J. Cantoni
Previously published in the Arizona Republic, December, 1999
Carol Moore never thought her life could get worse. Carol Moore was wrong.
A single mother with five kids, she has been victimized all her life by abusive men, by hardhearted
employers and by a system that is stacked against working women. Now on top of a lifetime of struggle, she
finds herself unemployed without medical insurance.
"I just don't know what to do," she pleaded to this writer in desperation. "One of my kids has severe asthma
and needs his medicine."
Wait. Before shedding a tear, you should know that Carol Moore is not a real person. She could be a real
person, though, since the chances are good that stories like hers could be found among the millions of
Americans without medical insurance.
The ideological battle over health care reform is being won by those on the left, because they know how to
find and exploit such human interest stories. Anecdote by anecdote, step by step, law by law, they are moving
the nation inexorably toward national health insurance. Their brilliant leader, Ted Kennedy, understands that
appeals to people's emotions will always win out over intellectual arguments.
Free-market advocates on the right are clueless about how to blunt the human interest approach to public
policy. What they should do is simple: Fight fire with fire.
They should preface every health care debate with a human interest story, similar to the first three
paragraphs of this article. Then, they should segue to their reform ideas. To see how they might do that, let's
pick up the Carol Moore story where we left off above.
[To quote the political opportunists:] "Something is dreadfully wrong in the richest country in the world
when a mother does not know how she is going to pay for her child's asthma medicine."
This is what is wrong: Misguided government tax and regulatory policies that stopped a consumer-led free
market in medical insurance from developing a half-century ago.
As a result, the majority of working Americans are dependent on the whims of their employers for their
medical insurance. Unfortunate people like Carol Moore, who lose their jobs or who do not work for rich
companies, face the Hobson's choice of paying exorbitant premiums for substandard coverage or doing without
Thank goodness this is not the case for other necessities of life as food, shelter and clothing. In fact, the
average American family now pays more in taxes than it spends on those necessities, thanks to a free
market that empowers the consumer and creates a plethora of options.
[People like Carol Moore are discriminated against in at least three ways when it comes to medical
insurance: (1) They must use after-tax dollars rather than pre-tax dollars, and thus have to earn up to twice as
much money as a person with employer-provided insurance to cover the same premium cost; (2) They are
subject to expensive state mandates; and (3) They can't buy a group policy (which is less expensive than an
One of the worst aspects of employer-provided medical insurance is that it benefits the higher-paid over the
lower-paid. Employer contributions for medical insurance are excluded from income, thus benefiting highly
paid, fat-cat executives more than working stiffs, because the highly paid are in a higher tax bracket. To add
insult to injury, corporate employees, unlike the unemployed or self-employed, are protected by the Employee
Retirement Income Security Act (ERISA).
The solution is simple, if Congress can stop its partisan bickering. Legislation should be passed to give
people parity with corporate fat-cats, nothing more, nothing less. It is only fair that individuals be given a tax
credit for their medical insurance premiums and the same ERISA protections provided corporate employees,
particularly the ability to buy insurance free of expensive state mandates. Further, the legislation should make it
easy for people to buy insurance from nonprofit associations, including religious, social, fraternal and charitable
Association-based insurance would have clear advantages over employer-provided insurance: It would be
portable, it would stay in effect for a lifetime, and it would solve the inherent dilemma of for-profit insurance;
that is, the conflict between Wall Street's interest in the bottom line and the people's interest in their health and
Carol Moore and her children deserve nothing less.
Pamphlet No. 1070, February, 2000