Is Obamacare a tax? The argument teaches us to stay healthy by disagreeing

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Sometimes our elected officials operate on such a high intellectual plane that their message can get lost.

Take, for example, the debate over President Barack Obama's health care overhaul law in the wake of theU.S. Supreme Court's declaration that the law is constitutional. To the untrained ear, the partisan bickering has been cacophonous. But what our lawmakers and political pundits are actually doing is showing us the true path to better health.

First, consider the evolution of the Obamacare kerfuffle.

It's well-established that if you're a Democrat, you love health care reform and want to marry it, and if you're a Republican, you hate it more than a 24-hour case of the Ebola virus.

At the heart of the disagreement is the individual mandate, which requires people to have health insurance or pay a penalty to the Internal Revenue Service. The president has always stressed that the penalty is "absolutely not a tax increase."

But when Obama's solicitor general, Donald Verrilli, argued the health care law before the Supreme Court, he referred to the individual mandate as both a "penalty" and a "tax," leading Justice Samuel Alito to say, "General Verrilli, today you are arguing that the penalty is not a tax. Tomorrow you are going to be back and you will be arguing that the penalty is a tax."

This should've been our first clue to the grand plan.

When the high court issued its ruling, it defined the individual mandate as constitutional under Congress' power to tax. That led every Republican living and dead to rise up and shout, "AHA!! IT IS A TAX!!"

To which Obama and the Democrats responded, "Is not."

And then a spokesman for Mitt Romney, GOP presidential candidate and current Republican standard-bearer, said: "That's right. It's not a tax." And all the Republicans said, "Wh-wh-wh-what?!?!?"

You see, Romney once came up with an insurance mandate of his own while governor of Massachusetts, and if he calls Obama's mandate a tax, then that might make people think Romney's mandate was a tax, and taxes make Republicans break out in hives.

On the Fourth of July, out of nowhere, Romney himself went ahead and agreed that Obama's mandate is a tax. He then assured everyone that the Massachusetts health care mandate was absolutely not a tax, causing such ideological whiplash that dozens of pundits' heads fell off their bodies.

But as one Republican strategist told The Weekly Standard: "It doesn't quite matter whether Romney calls this a tax, a penalty or a potato. Voters will call it a tax, and so will every other Republican candidate running for every other office."

Make sense?

Of course it doesn't. And THAT'S the key!

Democrats and Republicans, Supreme Court justices and televised talking heads have shown us that if someone tells you something you don't want to believe, just forcefully disagree and it stops being true. If you're a Republican, Obamacare is undoubtedly a massive tax increase on hardworking Americans. And if you're a Democrat — or Mitt Romney's spokesman — it's not a tax at all.

This is the perfect template for dealing with matters of our own health. Don't like what your doctor tells you? Disagree!

Say you go in for a checkup and the doctor says you have a bowel inflammation. Just say, "No, I don't."

Then if he keeps insisting that your bowel is inflamed, hire a representative to more clearly state your contradictory opinion. If possible, enlist the help of some anonymous millionaires willing to contribute to your "My Bowels Are Not Inflamed" campaign via a super PAC (Physician inAccuracy Committee).

The best thing about this approach is that even if your doctor was right in the first place, you will have spent so much energy disagreeing that your bowels will be too tired to remain inflamed. Clean bill of health.

I discussed this health care approach with Catherine Belling, an assistant professor of medical humanities and bioethics at Northwestern University's Feinberg School of Medicine and author of the book "A Condition of Doubt: The Meanings of Hypochondria."

I believe she agreed wholeheartedly with me, though she expressed that agreement by saying my conclusions were utter nonsense.

She did, however, say that our health care system would improve if medical educators focused more on teaching physicians to properly address patients' doubts and uncertainties about diagnoses.

"In the old days, you had the paternalistic doctor who said, 'Everything's going to be fine' or 'You're sick and take this and don't worry about it,'" Belling said. "Now instead of saying, 'You're my doctor and I trust you,' patients will say, 'There's this study that I found on WebMD that says X and you probably haven't read it.' It immediately undermines a physician's already tenuous confidence in what they do and can lead to a lot of unnecessary testing, which gets expensive."

While it can be good for patients to challenge their doctor's opinion — given there are few absolute certainties in medicine — it's possible some of us are taking that license too far.

"We're all encouraged all the time to be looking at ourselves as being potentially sick," Belling said. "There's a lot of pressure on people to make use of resources with the idea that if you get tested now, your disease will be identified and treated early."

But sometimes, she said, it's better for people to recognize this: "You will die eventually, you will get some form of disease eventually and there's nothing you can do about it at this point."

Which gets back to my original assertion that we should follow our political leaders' example and disagree anytime a physician says anything we don't want to hear.

I even came up with an easily digestible, catchy, carefully focus-grouped slogan: "Stop worrying. Save money. Die fast."

"Don't you dare attribute that to me," Belling said.

Don't worry, Dr. Belling. All the credit for that will go to my super PAC.

rhuppke@tribune.com

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