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, very few seem 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.
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.
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