DO AMERICANS DESERVE TO HAVE HEALTH CARE?

My answer is a resounding “NO!”  Prior to this recent fall 2016 local and presidential election, I was one of those naïve idealists who actually believed that everyone in America deserved health care.   I had three reasons: 

1.)  First, it is necessary to maintain your health, which falls under our inalienable right to “life, liberty and the pursuit of happiness” guaranteed to us in the Declaration of Independence;

2.)  Second, it is in everyone’s economic best interest to have broad health care coverage, both from a micro and macro viewpoint; and

3.) Third, we are the richest county in the world, and if other much poorer countries like Cuba can afford to provide health care to all its citizens, we certainly should be able to as well, if we make it a priority.

WHY I CHANGED MY MIND

The phrase “if we make it a priority” is the caveat that changed my mind about the answer to the question above.  You can tell from the results of the recent election that receiving good health care and possessing good health insurance for ourselves, our families and our fellow Americans is not a priority for the majority of Americans.  Most Americans put one or more other issues way ahead of having access to health care.  I can’t cite and don’t even know all of the issues that were given a higher priority, but examples are issues such as fear of a transgender in the restroom (even though they have been there for years and we just haven’t known it), fear of a gay married couple living next door, fear of having their guns taken away (which was never going to happen), the importance of making a protest vote or no vote at all to prove a political point, zealous concern about the environment, change for change’s sake without a clue as to whether the alternative would be better, dislike of a particular candidate, dislike of President Obama and anything even remotely associated with him, hatred of minorities and foreigners,  fear of big government in general, not to mention just an overall apathy or too little concern to bother to vote.   All of these non-healthcare issues seem trivial to me when compared to the threat to the physical and financial welfare of an individual and his/her family that result from having an accident or becoming ill without health insurance. Obviously, most Americans do not agree with me.  About the only issue that veers close to the importance of insurance coverage in its immediate effect on the health and quality of life of us and our loved ones is the fear of a terrorist attack.  The terrorist threat is frightening and is very real, but it is much less likely statistically to afflict any one individual versus the chances of becoming ill from any variety of diseases or accidents.  Another competitive possible threat is harm due to crime such as in the more violent neighborhoods in Chicago.  But even the survivor of a terrorist attack or a random crime will need good medical care and mental health care after the attack.  Let's remember how we let down our first responders to 911 who later became ill as a result of their heroic efforts.  Let's also remember the many domestic shootings that have occurred because the shooter could not get adequate mental health care.  And let us also not forget that we will all get old and frail if we are lucky, no matter what we do or believe.

DO WE DESERVE HEALTH CARE BECAUSE IT IS PART OF OUR INALIENABLE RIGHT TO LIFE, LIBERTY AND THE PURSUIT OF HAPPINESS?

Is it necessary to maintain your personal health and the health of your friends and loved ones to achieve “life, liberty and the pursuit of happiness”?  I think everyone would agree that maintaining your personal health is necessary to maintain one’s life.  While the sick are often happy (God bless them), it is easier to be cheerful when one has good health.  I’ve never met anyone who has ever said they would rather be sick than healthy.  It is also easier to pursue other personal and professional goals if you are in good health versus battling a physical or mental affliction.

So, in the United States, is it necessary to have health care insurance to maintain this good health?  In America, I would say “yes” due to the way our health care system is structured and financed.  Some people may argue that you can get free care at the emergency room if you don’t have insurance, so why pay premiums?  This has been true in the past but the health care received in the ER is more like a bandage than a fix.  There are provisions in the Affordable Care Act designed to encourage hospitals to perform post-discharge follow-up for hospitalized patients and to financially punish hospitals when they fail to do so.  A person needs routine medical evaluations, preventive medicine, pharmaceuticals and diagnostic procedures to remain healthy.  And don’t forget about hip and knee replacements!  You won’t die without these, our ancestors lived without them, but they certainly can improve your quality of life.

The real reason that I think health insurance is necessary in America to maintain good health is that EVEN THE RICHEST AMERICANS POSSESS HEALTH INSURANCE.  (On my trips to the Mayo or Cleveland Clinic I often see rich foreign leaders staying at the hotels and paying out of pocket for their US care.)  Yet the wealthy in the US buy health insurance even though they could easily afford to pay for their own. They purchase it because it helps them maintain financial stability and shifts the financial risk to the insurance companies.  If it were such a trivial matter, the wealthy would not bother.  Wealthy individuals have the extra benefit that if they do not like the treatment offered to them by the insurance company, they can buy their own if necessary.  This is why we don’t see Congress giving up their health care.  We pay for their health care while they take ours away.

If I were to ask you, do you accept the premise that we have an inalienable right to “life, liberty and the pursuit of happiness” as stated in the Declaration of Independence, most Americans would answer “yes” without even giving it a thought.   An argument can be made that all Americans are entitled to health insurance because they need health insurance to have access to health care, and they need access to health care to remain healthy.  An “inalienable” right is a right which cannot be taken away or given away by the possessor.  Ironically, that is exactly what the repeal of the Affordable Care Act will do, take away an inalienable right from many Americans, most of whom knew they were taking that risk when they made their votes in the 2016 election.

DO WE DESERVE HEALTH CARE BECAUSE IT IS IN THE ECONOMIC INTERESTS OF EVERYONE?

Prior to the Affordable Care Act, many talented company employees with a pre-existing condition, such as a cancer diagnosis within the past five years, or a chronic incurable condition such as diabetes, were afraid and/or unable to move to a better job because they were dependent on their current employer for their insurance.  If they jumped to a better job, their new employer’s insurer could declare their pre-existing condition uninsurable.  As a result they would be without insurance, and quite frankly, it just wasn’t worth it.  This holds back the economy on a micro level.  Likewise, those employees that were thinking of striking out on their own and starting their own business found it difficult, if not impossible, due to the availability of insurance and its cost.  How often has a politician told you it is the small businesses that drive the economy? This economic benefit on a personal level is not a priority to most Americans, as I have stated above.

At a macro level, uninsured people increase overall health care costs because they wait until they are seriously ill to get treatment and go to the Emergency Room to get their care, which is much more expensive than a routine visit to a neighborhood clinic.  A healthy citizen is more likely to be a productive citizen.  Addicts who cannot receive treatment will remain addicts.  In addition, health care costs gobble up a large portion of our Gross Domestic Product compared to other countries.  On a macroeconomics level, this is a complex issue that few understand.  But I can guarantee you there will always be a market and a demand for health care because it is not a luxury item.  It will not go away, and it will always be the elephant in the room when analyzing the competitiveness of our economy.

DO WE DESERVE HEALTH CARE BECAUSE AMERICA CAN AFFORD IT?

This argument is raised the most frequently, and its rejection is the most puzzling to me.  It is the strongest evidence I have that we, individually and collectively, as Americans, do not value and/or prioritize access to health care.  I think of a Latin phrase I learned in law school, “res ipsa loquitur”, which means "The thing speaks for itself”.  The mere fact that we are the richest country in the world yet many of our citizens are not covered is really all you need to know.  And the recent fact that many citizens voted against the recent enhancement of health insurance coverage in the 2016 election, even when it may have been against their own personal interest to do so, confirms my point.

NO, WE DON’T DESERVE TO HAVE HEALTH INSURANCE AND WE DESERVE IT EVEN LESS NOW, SO PLEASE STOP COMPLAINING ABOUT THE REPEAL OF THE AFFORDABLE CARE ACT UNLESS YOU PERSONALY VOTED TO RETAIN IT!

I used to believe in health care for everyone.  Now I no longer do because this recent vote was a repudiation of expanded health care coverage.  Politicians were very clear during the election where they stood in regards to the upcoming repeal of the Affordable Care Act.  I hope the people that are complaining at the personal level, and on social and traditional media, voted in this past election to keep America insured.  If so, I feel sorry for you and I wish you the best.  If you did not vote to retain expanded coverage, but now complain, shame on you. You are getting what you deserve, which very well may be nothing.