I don’t like saying “I told you so”, but I did, and the failure of the first phase of “repeal and replace” will make it all the more difficult to do so. But rather than wander into the weeds of policy options and tactical moves at this point, I think that there is a larger philosophical issue that has become central in a way that it really hasn’t throughout the debate until now. Charles Krauthammer picked up on it recently as follows: “……..there is an ideological consideration that could ultimately determine the fate of any Obamacare replacement. Obamacare might turn out to be unworkable, indeed doomed, but it is having a profound effect on the zeitgeist–it is universalizing the idea of universal coverage. Acceptance of its major premise–that no one be denied health care–is more widespread than ever.”
It’s the age-old question–is health care a right? And Krauthammer is correct; the notion of health care as a right is more firmly entrenched than ever, even though we have never really had the national debate on this question, at least in the open. When Franklin D. Roosevelt rolled out his “second bill of rights” in his January 1944 State of the Union address, one of the eight additions to the original ten was “the right to adequate medical care and the opportunity to achieve and enjoy good health”, and probably not many people flinched, but there was also not much debate about the enormous implications of these new “rights”, at least outside the ivy-covered walls of the philosophy departments of academe.
I looked back at the failed attempt by the Clintons to install Hillarycare in the early days of their administration and discovered an interesting chapter in “The President’s Health Security Plan” entitled “Ethical Foundations of Health Reform”, which listed the values and principles that shaped the proposed new health care system. At the top of the list of 14 principles was “Universal Access: Every American citizen and legal resident should have access to health care without financial or other barriers”. Stunning, but I don’t remember a lot of debate on it.
My point is this–for every right there must be an obligation to defend that right, and in this case fund it, and we haven’t yet really had the national debate we need to have before we put in place a health care system in which a right to health care is the centerpiece. Maybe the conclusion will be in the affirmative and I don’t have much doubt that would probably be the outcome, but if so, then the resulting health care system will inevitably and soon evolve into a universal single-payer system. And does anyone believe that there will not be rationing of care? And who will do the rationing? Maybe we should spend some time discussing the implications of these points and even brush up on the philosophy of rights.
Jim,
What I have never understood is why a bill in Congress seems to always have to be a comprehensive bill. Why not pass separate bills that most in Congress could agree to. Free market solutions addressing cost of care. Tort reform which would eliminate unnecessary tests, etc. If universal health care would be passed the cost issue would never be addressed and as you say we would have rationed care. As a small businessman selling his product DIRECTLY to the customer I have always envied Walgreens where the customer does not care how much the product costs as his employer’s insurance or govt insurance is paying for it. UNTIL the customer is paying for the product as with health savings accts, etc. health care cost will not change.
I have shared this writing with hundreds. Too few of my fellow citizens have been educated in the principles of government to engage in a discussion regarding the powers of government vs. the ‘rights’ of citizens. The principles articulated in our founding documents are not well known, understood or revered by present generations.
The Republican Party is not gifted in taking the message of the dangers in this ignorance and the debates spawned by it. The media are largely propagandizing the progressive view which can lead only to a nanny state.
Jim spent most of my life in the healthcare industry and watched it’s demise beginning with Medicare. The fact that people believe or think that healthcare is a right in the current society comes as no surprise but what will come as a shocker if we go to universal healthcare (even with rationing) it will run the national debt up so quick and to unsustainable levels that the repercussions to all (business and individuals) will most likely cause a financial collapse in the US. There are solutions to the healthcare dilemma however they are tough. An interesting thing that has happened over the last 50 years is the 501C3s like Methodist, Memorial Herman, MD Anderson, and the list goes on is the fact that the concept of charity care has slipped away and there is no difference between the non profit and for profit hospitals except the latter pays taxes. In the early 80s the lawyers changed the game for the non profits and allowed them to count the medicare contractual adjustment along with the medicaid contractual adjustment as if it were charity!! Otherwise most 501C3s would have lost their tax free status.
This is getting too long. I will write my disertation later :-)