During Tuesday's Supreme Court oral arguments about the Affordable Care Act's individual mandate, the Justices and the lawyers spent a lot of time talking about young healthy people. The conservative Justices in particular were worried about making young healthy people pay for a product (health insurance) they don't need. So much attention was paid to this issue that the fate of the tens of millions of uninsured people in this country may just come down to whether Chief Justice Roberts and Justice Kennedy think the law is unfair to a bunch of twenty year olds with a false sense of invincibility.
When listening to the audio of the argument yesterday morning, something came over me that I hadn't connected with this case before -- they were talking about me. No, not me now, but me from 19 years ago. And, considering the Justices' concern Tuesday about young healthy people, I am an excellent argument for this law.
Almost 19 years ago to the day, I was a perfectly healthy twenty year old enjoying life as a junior in college. I was slim, fit, and athletic. I ate reasonably well (for a college student), didn't drink or smoke, and got a good amount of sleep (even if at odd hours of the night/day). I gave my body no thought because it worked perfectly.
Until it didn't. After getting a pretty ordinary tooth/gum infection and being prescribed amoxycillin, a drug that dentists prescribe like water, I had an adverse reaction to the drug. My body deteriorated in a way that still shocks people in the medical profession, who seem to listen to my medical history and look around to drag their nearest colleague into the room to hear the story because they know no one would believe it if they didn't hear it straight from the patient's mouth.
Three weeks after taking the amoxycillin, I was rushed to the hospital and underwent emergency abdominal surgery to remove 1/4 of my large intestine, which had become so infected that it was essentially useless (and had a great name for the condition - toxic megacolon). Over the course of the next year, I spent thirty days in hospitals and had four different surgeries. I had a colostomy for 6 weeks, a severe wound infection that required months of excruciating care, and off and on abdominal pain that affected my every movement.
I'm perfectly fine now, with no real lasting effects other than some interesting scars on my abdomen (and no belly button, which makes my kids laugh). That is, no real lasting effects except the risk, that I'll live with for the rest of my life, that at any moment I can return to the hospital again with an abdominal obstruction, something people who have had both have said is pain that's comparable to childbirth. It's happened three times over the past 18 years (on top of twice in the first year following the incident) and could never happen again . . . or could happen while I'm writing this blog post.
My year of treatment back in 1993/1994 cost several hundred thousand dollars, possibly close to half a million. My three subsequent hospitalizations probably approached that amount as well. I have been hospitalized in three different states and cared for by doctors in at least two others. Forget about the aggregation principle from Wickard v. Filburn. I alone have had a substantial effect on interstate commerce.
But I was lucky. I was born into a family with two parents who made a very comfortable living. My father's job provided health insurance for the entire family. And I, the perfectly healthy twenty year old who didn't have a concern in the world for his own health, didn't have to worry about what would have happened had I failed to act on my own because of a misperception of invincibility and wound up at the hospital uninsured yet needing emergency surgery.
I would have gotten some level of emergency care (EMTALA was passed 7 years earlier) but would I have had the same level of care? Would my surgery have been delayed and the risk of death I faced, which I learned later was quite real, would have increased? Would my follow up care have been the same? Would I have a permanent colostomy now because the follow-up surgery that reversed it would not have been emergency surgery? Would my family be crippled economically having to pay those bills? Would my siblings not have gone to college because my family would have to pay for me to be alive?
I could go on, but I'll stop there. Nineteen years ago, I was that invincible healthy young person the Justices were talking about Tuesday. And then, all of a sudden, I wasn't . . . and I was thrust into interstate commerce in a clear, indisputable, and substantial way.