I believe very fundamental ideas are embodied in the Affordable Care Act (ACA) that continue to get lost in the shuffle due to the angst surrounding the law since it passed six years ago. Our values as a nation must count for something. I believe it is all about values and the character of a nation that matter when talking about health insurance and health care. The ACA is here and it is likely too late to have a national conversation as a starting point to discuss values surrounding health insurance.
Let’s talk about this. Among the human rights we should hold dear is health care, without which human potential is seriously impeded, if not denied. Shouldn’t there be an obligation to contribute to the health of the individual, which by its very nature helps society?
Of course I recognize the American passion for independence is both political and personal. But in this day and age let’s get real. We as individuals are dependent on health insurance to help us thrive – and survive – in today’s environment (maybe just sleeping better at night as a starting point).
How many people can really say that they do not care about having health insurance coverage for themselves or for their families? You would be deemed irresponsible by your friends, peers, colleagues at work, and by your family if you did not have health insurance (affordable, of course, and that is where ACA subsidies and Medicaid expansion come into play).
We Americans, I thought, support the “underdog” and more important, commitment to providing to all the opportunity to succeed. If we deny subsidies and coverage due to pre-existing condition limits, to people who really need those things to thrive, then we have fallen way too short of that standard. Health insurance is all about fairness and equality of opportunity reflecting a common good.
Health insurance is an essential building block in today’s society like universal education whose purpose is to preserve fairness and equality by breaking down of barriers. Prior to the ACA, even those with health insurance knew that an individual was at risk not only for the possibility of ill health that can threaten independence, but the loss of coverage which is the principal protection against the worse effects of sickness.
So instead of double indemnity, they faced double uncertainty. Under those circumstances, it seems that our commitment to the notions of independence, fairness and equality were compromised. The ACA has addressed those issues. Do we want to go back to those days and place a key building block in grave jeopardy? Health insurance and health care are important at every stage of one’s life. Lack of access at any stage, is a potential threat to personal independence and the pursuit of opportunity. It is a building block like universal education, police and fire protection, roads and running water.
Recognizing health insurance and care as an essential building block offers a framework rooted in the American opportunity ethic. It provides individuals with a critical tool for taking advantage of their opportunities, and it provides individuals and families greater opportunities to participate in and contribute to the fabric of their communities through religious, social, and voluntary institutions. This is not all a one-way street. There is a reciprocal obligation on the part of citizens to respect and care for their own health. By making health insurance an essential building block, it serves society’s legitimate self-interest in promoting a healthy, productive citizenry.
To put it another way: The provision of health insurance and health care through consistent coverage should be essential to an authentic realization of the American values of independence, fairness and opportunity.