Context Matters

To understand something, you must know the context in which it occurs. Take, for example, the phrase, “No need to dress for dinner.” Its meaning differed markedly when uttered on 1930s Park Avenue or 1960s Haight Ashbury. In the former, it meant, you don’t need to put on white tie and tails – what Bertie Wooster called ''the full soup-and-fish”. In the latter, if you came over in anything more than your sandals, you’d probably be overdressed. So too with Obamacare. Some people are so pathologically obsessed with it that they drown out rational debate with barrages of invective against the law and the man for whom it is named. Others, however, talk reasonably about the program’s huge future costs and the unseemly legislative process that turned a good intention into a garbage bag of special interests. We should listen to them. But I hope we also consider the full context of the national conversation. America has over 48 million people without health insurance, which among other things causes 48,000 preventable deaths annually. Estimates of covering them are high: a 5% increase in health spending, about 1% of GDP. The costs of not covering them are staggering on two levels. The first is the impact on our economy from the combination of ultimately higher treatment outlays and lost productivity of the uninsured, both of which are eventually borne by taxpayers. The second is the impact on our community from tolerating the presence of such a large marginalized group. Life is short; dignity is precious.