Any day now the Supreme Court will announce its decision on the constitutionality of the Affordable Care Act’s requirement that all Americans buy health insurance. It will answer a question it should not have had to, a question asked because of the prevalence and power of certain assumptions that have led to the acute economic, social, and political exclusion of countless Americans. Asking whether or not the government – any government, be it local, state, or federal – has the right to require and force a citizen to buy health insurance, especially from a privately-managed, for-profit corporation benefitting from a good bankroll and weak regulation, is to ask the wrong thing. Instead, the question before the Supreme Court should be whether or not it is constitutional for government – especially the national government – to not provide citizens unfettered access to comprehensive healthcare regardless of economic condition.
The definition, or at least reality, of insurance is partly to blame for the healthcare debacle, but that’s part of the greater problem. In a real sense, an often cruelly effective one, our world has become too arbitrary, as even the fundamental systems on which most people rely, such as employment, are subject to the whims of fewer and fewer unaccountable individuals or their corporate shields. Furthermore, law, abetted by social convention and lack of care or understanding, increasingly constrains even the most decent person who, unjustly brought to court or wronged and seeking recompense, must wade or be dragged through a process that typically ends badly, wasting effort, resources, and time. But in this equation time is life, and once passed it never returns.
The same is often true in landmark political decision making. This nation now has an opportunity to provide all its citizens with full healthcare. Those exercising the power to make that happen should curb their cynicism, linguistic gamesmanship, and rancor to see it happens. Current medical services afforded through social services are generally mediocre at best, gutted by state legislators and governors so they fail to provide eye or dental care (your teeth may be pulled but not filled; root canals are defined as cosmetic so they’re not covered; etc.) despite obviously bad medical conditions and harm or death resulting. Furthermore, all of that costs more money than the appropriate medical care given at the start would have.
I’ll use Massachusetts’ MassHealth for an example since it is touted by both political parties as a model of efficiency for social service healthcare. Note that efficiency is used as for economics, and that always means something good only for major investors. Mr. Romney’s idea of managing health insurance and medical care is a failure, and even under Deval Patrick MassHealth is a disaster. It routinely eliminates people from coverage and refuses eligibility or service to patients. When allowing service at all, it permits use of only the lowest-grade products, such as decades-old eyeglasses or sometimes dentures, in order to reduce welfare rolls and costs. MassHealth is also so lax in administering its business and paying physicians for their services that many well-intentioned medical practitioners severely reduce or quit their involvement with the state’s plan. That is part of Mr. Romney’s legacy in Massachusetts. Such practice might be considered good business at Bain Capital, but lowering costs by refusing healthcare to people who don’t make enough money to matter socially is immoral and not my idea of good government or social responsibility.
Health care and insurance are necessary. They help maintain the fabric of society and life, so they should be spared application of the crude risk and cost analyses used by intelligence agencies or mergers and acquisitions departments of the Fortune 100. Health insurance is not legitimately a tool for corporate profit, nor is access to thorough, excellent health care rightfully exclusive in a nation become so rich in the aggregate during as interdependent an era as ours.
Good reading and good day!
Brian D. Sadie