Healthcare For All? part two:
Healthcare in the United States is viewed as a service, offered by private, for profit providers and, for the most part, paid for by individuals who purchase insurance, largely through their employers, from for profit insurance companies.
For the vast majority of citizens this method has worked very well and has provided excellent care. However, the cost of care, and insurance, has skyrocketed, far outpacing the rate of inflation and leaving a growing group of citizens without the means to pay for medical care, or even without access to care. Unpaid medical bills are the number one cause of personal bankruptcy.
The Affordable Care Act has attempted, with mixed results, to create a public/private partnership to help those with no private options available or affordable to secure coverage. Also, some states have conducted an expansion of Medicaid into working poor, underserved communities in an attempt to provide basic care for treatable conditions like infectious diseases, infant mortality, and substance abuse that take more lives in the United States than in any other developed nation.
Still, many are not satisfied with this move toward a solution. Some want to scrap the act entirely, and others rail for a single payer plan to cover everyone, Medicare for all.
At the core of the debate must be the question of whether or not we view healthcare as a human right to be paid for by society.
As we look at countries stricken by extreme poverty, where NGOs are called upon to provide much of the basic care a people require, most of us nod and agree that yes, help is deserved by these underserved and abused populations.
When we consider moving government to provide the same level of care to the impoverished in the United States, many of us decry the solution as socialism. But almost no one expects NGOs to step in and solve the healthcare crisis here. So people remain without.
The Nobel Prize winning economist Amartya Sen skirts the usual, polarized argument by insisting on including economic rights such as healthcare, shelter, and sustenance as equal rights to those guaranteed in the Bill of Rights. That he does this from a pro-market, pro-development point of view is unique, and I highly recommend his book Development as Freedom as an excellent primer on this idea that, in a way, solves the divide that separates the capitalist and socialist extremes in the United States.
While we must always be vigilant in surveying the effects of increased government involvement in the market, the higher taxes that come with it, and the insurance fraud that complicates it, we must primarily approach the issue of healthcare as a right from an ethical perspective as strong as the political one that entrenches our positions on what is a right and who provides or protects it.
Most of us live comfortable lives and never encounter poverty without access to healthcare, so we truly know very little about it. But it exists and it is ethically wrong. And states like Ohio that have directed their Medicaid expansion dollars toward the problem of substance abuse have seen suicide and accidental death rates plummet along with the cost of care for co-morbid conditions and welfare for people left jobless and children left parentless by bad medical results.
Only extreme partisans condemn altruism, and the tiniest fraction of the population thinks sick people should be held responsible for their illnesses (this is not an uncommon view when people speak of mental illness and substance abuse) and left to fend for themselves. But that’s what we have.
Perhaps by viewing healthcare as a human right, which people on both sides of our polarized society may be able to do, we can forge a uniquely American solution to our healthcare crisis that is both pro-market and compassionate… and offers social justice, another argument made convincingly by Amartya Sen, for all.
See part four, “Compassion in the Healthcare Debate” here
See part three, “Healthcare as a Human Right: The Case Against” here
See “Healthcare for All? part one” here