Mary Brown, oppo­nent of the PPACA indi­vid­ual mandate

Mary Brown is one of the plain­tiffs in the case to over­turn the Patient Pro­tec­tion and Afford­able Care Act (PPACA or Oba­macare) require­ment that all Amer­i­cans have health insur­ance. This require­ment is com­monly referred to as the “indi­vid­ual man­date”, and its con­sti­tu­tion­al­ity is being decided by the Supreme Court right now.

Brown’s argu­ment was that her fam­ily doesn’t need health insur­ance because they are per­fectly capa­ble of pay­ing for their own health­care. U.S. Dis­trict Judge Roger Vin­son noted, with regard to Brown’s com­plaint, that “She is a small-​​business owner … [who] does not believe the cost of health insur­ance is a wise or accept­able use of her resources.” To Mrs. Brown, the man­date merely requires her to pay for the insur­ance com­pa­nies’ over­head, and that is unacceptable.

But a funny thing hap­pened on the way to the Supreme Court. Last fall, well after fil­ing her objec­tion to the indi­vid­ual man­date, the auto repair busi­ness the cou­ple ran in Florida failed. The cou­ple filed for bank­ruptcy. Sig­nif­i­cantly, the cou­ple has unpaid med­ical debt…precisely the sit­u­a­tion the indi­vid­ual man­date is sup­posed to combat.

The Browns’ unpaid med­ical bills join the nearly $58 bil­lion in annual unpaid med­ical bills. Who pays those bills? About $43 bil­lion comes directly out of our taxes, paid from the gen­eral funds. The rest is borne by the med­ical facil­i­ties, who recover a por­tion of their loss through increased fees for ser­vice, which trans­lates into higher med­ical insur­ance pre­mi­ums for those who are insured.

In other words, when Mary Brown doesn’t pay, the rest of us must pay for her.

Of course, we have the option as a soci­ety to sim­ply refuse to treat the Browns. But aside from Ron Paul Lib­er­tar­i­ans, there doesn’t appear to be much sup­port for that option. And we have the option of con­tin­u­ing as we have, with every one of us pay­ing more so that the Browns can pay less. Yet that is a pol­icy in oppo­si­tion to per­sonal respon­si­bil­ity. Given that the Repub­li­cans — the party who claims to be in favor of per­sonal respon­si­bil­ity — opposes the indi­vid­ual man­date, and the Democ­rats — the party who Repub­li­cans claim to be in favor of mak­ing tax­pay­ers cover irre­spon­si­ble behav­ior — sup­port the man­date, it seems that the per­sonal respon­si­bil­ity meme is not sup­ported by the evi­dence here.

Or we have the option of requir­ing that peo­ple be fis­cally respon­si­ble for their health­care coverage.

I’ve pointed out many times that I sup­port per­sonal respon­si­bil­ity. I do so here as well. And as long as we as a nation agree to pro­vide health care to all who need it, regard­less of the abil­ity to pay, then we as a nation need to ensure that those who receive med­ical treat­ment do so responsibly.

Mary Brown, a plain­tiff in the case oppos­ing the indi­vid­ual man­date, is her­self evi­dence of why we need the indi­vid­ual mandate.

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