Let Them Eat Tofu: Whole Foods CEO On Health Care Reform

John Mackey, the Whole Foods CEO, channels Marie Antoinette in his 8/11/ 09 Wall Street Journal editorial on health care reform. Marie, at least in the apocryphal story, was told that the peasants had no bread and responded "let them eat cake." Mackey has updated Marie's message, but retained her logic.
In Mackey's updated version, uninsured Americans substitute for hungry French peasants. The alternatives to reform that he suggests substitute for cake. The cake has three main ingredients.
First, Mackey argues that adjustments to the tax structure would solve a great deal of the problem. Legal obstacles to health care savings plans could be repealed. Individual contributions to help the uninsured could be incentivized through the tax code. The tax status of individual and employer-provided plans could be equalized.
Each of these propositions has its own difficulties. HSA's, first of all, are rarely provided by low-wage employers and they are rarely attached to temporary jobs and, secondly, would not be particularly useful for families where virtually all income goes toward housing, utilities and food.
As to the role of the tax code in stopping the stampede of well-off Americans who would otherwise be contributing to health care for the uninsured...a determined philanthropist would hardly be put off by existing arrangements. And, finally, Mackey does not tell us in what direction he would like equalization to occur--should individual plans (which are not affordable for many families in any event) become deductible, or should employer-provided benefits be taxed?
Mackey's second set of suggestions involves providing more assistance to a truly beleaguered sector - the insurance industry. Insurers, he opines, are hampered by their inability to compete across state lines and by federal mandates that require them to provide coverage for certain individuals who are at higher risk.
The last point, of course, is just silly: granted, rates might decrease somewhat if risks could be excluded, but what about the people who are insured only because of these mandates? Wouldn't their repeal increase rather than reduce the number of the uninsured? As to the first point, it is possible that competition might occur, but given the relatively small number of insurers and the strength of their common interests, it seems more likely that this would increase the probability of cartel-like behavior that would further harm consumers.
And so we come to Mackey's third line of argument. This is quite innovative: people who become ill have only themselves to blame. Individuals who eat a healthful diet and maintain a healthful lifestyle are unlikely to become ill, he assures us. Well, sometimes this works out, although often it does not. Does Mr. Mackey, who is presumably the poster child for this line of argument, bother with insurance for himself and his family? After all, they would hardly need it.
This argument does, however, provide an anodyne for any lingering idea that we might, as a society, have any obligation to help those in need of medical care. Of course, those uninsured low-wage single moms who drag themselves home after 8 hours of, say, lifting, turning, and bathing patients in a nursing home may not have the energy to fix a tasty, plant-based, low fat meal for themselves and the kids, even if they had the money to buy the ingredients or a way to the nearest organic market. And they might even be a little stressed from the various difficulties in their lives, although Mr. Mackey does not factor in this empirically-verified cause of health difficulties.
But never mind. Mr. Mackey is not making an empirical argument at all. His concerns are normative. He is, after all, both CEO and political philosopher, as we discover at the end of his argument. " Many promoters of health-care reform," he tells us," believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?" And he assures us that a "careful reading" of the Declaration of Independence and the United States Constitution will demonstrate that no such right exists.
Now, I'm no political philosopher, but I recollect something in one of them about the right to "life", right there with " liberty" and "the pursuit of happiness." Is it just me, or is it hard to sustain life without food, shelter or medical care?
Cake, anyone? John Mackey has lots for sale, and some of it is even organic.
To read Mackey's editorial see

http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html

He responds to the furor over his article in the following selection from his blog:
http://www2.wholefoodsmarket.com/blogs/jmackey/2009/08/14/health-care-reform-full-article/#comments
For my money, this response simply makes things worse!

For a report on the demographic characteristics of the uninsured see
http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm#Conclusion