Since Donald Trump’s inauguration, the GOP has spent the majority of its legislative efforts on one thing: repealing the Affordable Care Act. Thus far, their efforts have been for naught; the ACA has remained the law of the land, though not for lack of trying on the part of congressional Republicans.
I’ve written extensively on this topic in the past, so a rehash of the various arguments seems fruitless; moreover, these arguments are primarily focused on the legislative ins and outs of the bills introduced by the GOP thus far. And though it is worthwhile to discuss the nitty-gritty elements of how these bills might work in practice, the underlying question is more important: should healthcare be considered a privilege or a right?
According to the United Nations Development Programme (UNDP), the United States is the only highly-developed nation in the world (a group consisting of roughly 50 nations) which does not offer universal healthcare that “cover[s] substantially all of their population.” Logically speaking, there is no good reason why this should be the case. Health care costs in the United States are higher than nearly everywhere else in the world; on average, Americans spend in the neighborhood of $10,345 per year on healthcare.
Part of the reason for our inflated costs is because without health insurance, people don’t go to the doctor. And when people don’t go to the doctor, minor afflictions that might otherwise be quickly and effectively treated can spiral into expensive medical catastrophes — curative medicine (i.e., treatment) is exponentially more expensive than preventative medicine. There are economic benefits to a healthy populace, too: a study by KPMG found that an increase in government spending on a universal healthcare program correlates to an increase in national economic activity. Why? Because a healthy workforce is more productive.
Even for a country as singularly obsessed with wealth and economic productivity as the United States, this information has done little to sway the opinions of conservative lawmakers. In their view, healthcare is a privilege. The Republican ethos has long been one of personal responsibility and limited government, so it isn’t necessarily surprising that Republicans feel the government shouldn’t play a role in the healthcare of private citizens.
In the GOP’s view, healthcare is like any other private industry: let the free market do what it does, consumers can make their own choices, and in the end, healthcare providers will figure out the precise amount that the market will allow them to charge for each and every procedure without losing customers. On paper, the logic seems sound, but in practice, the consumer is operating at a disadvantage almost from the start.
First off, such a market would require transparency on the part of the various companies in the healthcare industry: their costs and expenses would be public knowledge so that consumers could know exactly how much they could spend with Insurer A compared to Insurer B. But healthcare companies don’t work like that; in fact, these companies are known for making their fee structures as opaque as possible. It’s not just insurance companies, either: prices can fluctuate wildly depending on the hospital you use, which makes it almost impossible for the consumer — i.e., you — to determine if they’re getting the most value for their money. In order for a free market to work, everybody (consumers and businesses) needs to be guided by the same information. When one party isn’t privy to all the information the other possesses, it’s not a market at all; it’s little more than an extortion racket.
There is a difference between a dispassionate government and a disinterested one. The fact of the matter is, health care costs in the United States are out of control, and for the average person, an unexpected medical crisis would present them with a terrible dilemma: go into massive debt trying to treat their condition, or cross their fingers and hope for the best.
Let me repeat that. Prior to the passage of the Affordable Care Act, in America, a country described by some as the world’s only remaining superpower, citizens are routinely forced to decide between crippling — and often multi-generational — debt and death. The GOP would have you believe that the ACA is an affront to American values and a slap in the face to hardworking citizens who don’t want the quality of their coverage dragged down by freeloaders. They would have you believe that not having to make the choice between dying or saddling yourself with hundreds of thousands of dollars in medical bills (which may or may not prevent you from dying) is just not the American way. They would have you believe that healthcare is a privilege.
What the GOP conveniently leaves out in that argument is that most often it’s the citizens holding down two part-time jobs (which, prior to the ACA, meant they were unlikely to receive health insurance unless one of their employers happened to be incredibly generous) who get screwed. This debate has been politicized to such an insane degree that it’s not even really about healthcare anymore; rather, it’s dictated by the role each side thinks government should play in the day-to-day lives of citizens.
So, if possible, let’s strip away the political rhetoric and look at it simply as a simple, black-and-white question: should healthcare be provided to all, or should it be reserved for the more fortunate among us? It seems unfathomable that anyone would seriously argue the latter point, just as it is unfathomable that one might contend that homeless people don’t deserve shelter and a warm place to sleep.
The position that healthcare is a privilege is one that only be taken by those who are in no danger of ever going without it. Those who complain that universal healthcare would “limit their options” would do well to remember that under our current system, they have no clear idea of what their options even are. Private citizens who grumble about the “added cost” of universal healthcare should also be reminded that at some point or another, nearly every single person in this country will require extensive medical care.
Similarly, knowing that there are millions of Americans struggling to stay alive and financially afloat — and not caring because hey, they’re not you — is an attitude so devoid of empathy as to be nearly inhuman. To those who bleat about how unfair it would be to have to help defray the medical costs of other human beings (costs that, again, will inevitably apply to you as well), consider this: The salaries of firemen are also a government expenditure, which means you help pay for them to work. Wouldn’t you rather have firemen than a system where some houses get saved and others just burn down based on little more than sheer luck? (Also consider that some sources project that Bernie Sanders’ single-payer proposal would save roughly $17 trillion in healthcare costs over 10 years.)
But, again, these quibbles are frivolous distractions. From where I stand, the debate over universal healthcare seems like a no-brainer, but apparently the jury is still out. So the next time you find yourself weighing the merits of a piece of legislation, remember that this debate, at its core, is about one question: should everyone have the opportunity to live as long and healthy a life as possible?
If you’re unable to answer “Yes” to as cut-and-dried a question as that one, then I truly pity you.
This piece originally appeared on TrigTent.