March 15, 2017
The debate about the Affordable Care Act, the attempt to repeal and/or replace it, is an invitation to examine the core values embedded in the various assumptions of the discourse. Three values that have become apparent are: the primacy of financial considerations, an individual’s freedom, and the right to health care for every human being.
Financial implications, for example, are emphasized in the March 13, 2017 email issue of “The White House” proclaiming, “Americans were promised that Obamacare would bring down healthcare costs… Americans were promised that Obamacare would not raise taxes on the middle class.” Senator Rand Paul said on Face the Nation, “we’re not going to vote for it” (Ryan’s plan) because it creates a system of refundable tax credits. In addition, the recently released Congressional Budget Office analysis focused on costs of insurance premiums and federal deficit reduction.
Representative Paul Ryan, speaking on CBS’s Face the Nation, March 12, 2017, advocated for the primacy of the value of an individual’s freedom. He seeks to eliminate any mandate on individuals to buy insurance saying, “People are going to do what they want to do with their lives because we believe in individual freedom in this country.” He proposes a plan where people are free to buy insurance in the private market. Also, National Public Radio interviews with people who are critical of ACA reveal a positive attitude toward acquiring health insurance but a resistance to any “mandate” telling them they must have it.
The problem with being guided by the primacy of economic considerations traps us in a debate about the value of a healthy human being and which of us has earned the right to be healthy. Adhering to the mantra of ‘individual freedom” leads us into a society where every person must fend for him/her self. Both of these approaches are divisive and contrary to the vision of freedom and justice for all. They ignore the reality that we’re all in this together. The freedom and health of each individual affects the freedom and health of our communities and nation.
However, there is a value that can serve us well in the debate about health care in our country. Senator Annie Kuster, in a March 10, 2017 e-mail, suggested valuing the importance of health care for every human being. She wrote, “I am ready to get to work to… find ways to help improve healthcare for every citizen.” Logically extending her focus on improving health care for every citizen invites us to begin a serious discussion by first seeking agreement to value good health for all human beings, no matter who they are, their economic situation, or where they live.
Some cynics will suggest that it is the nature of human beings to center on individual and family fortune. For example, in the current debate of ACA some healthy young people say, “I don’t need health insurance so why should I pay for the coverage of those who are unhealthy?” However, there is another side of human nature that may be worth cultivating. Consider the times and situations that bring out empathy and care for others. How often have we observed the ways people rally after a natural disaster or a tragedy in the life of an individual, a family, or a community. People are energized and heartened as stories are told about volunteers contributing their time, skills, and money to support victims. People celebrate these situations as evidence that human beings are really good people supportive of their neighbors. It seems, in times of crisis the glorification of rugged individualism is subverted. The people of our country have a history of standing with each other. In the early years it took a village to raise a barn. Not so long ago, neighbors would help one another get the hay in before a thunderstorm descended.
It is time to refocus the healthcare debate based on personal economics and individual freedom values to the basic value of communal support for every person in our society. Contributing to this discussion can be the many stories and examples of empathy and commitments to helping others in need. In the course of the conversation the evolving nature of the human condition may surface. Could it be that rugged individualistic self-interest is giving way to communal concern? The task for elected officials and the American people will be to embrace this new possibility.
With this groundwork, the means of developing a healthcare system of economics that shares wealth and benefits and a society that recognizes freedom to be supportive of one another will begin to fall into place. Returning to the barn-raising example, once we agree that a barn is needed to shelter a given number of animals and store a given amount of hay, the details of the shape and size of the barn will soon be resolved. In the same way, when we agree we are together responsible to provide adequate healthcare for all people, the economics to make it happen will take shape. It will be a triumph for our basic cooperative human nature working for a greater America.