Last week, Rep. Paul Ryan (R-WI) introduced the Affordable Care Act’s replacement with a dense and flashy PowerPoint — the American Health Care Act. For some, the problems are in the details. The new “Trumpcare” gets rid of the individual mandate, bases aid on age and takes away healthcare from the needy. For others, the repeal doesn’t go far enough. For six years, conservative leaders promised to repeal the ACA, instead, they repackaged and gave it a different name. In short, it’s a controversial bill opposed by Democrats and conservatives alike and would cost 15 million people their health insurance.
The problem with healthcare in America isn’t the partisan details — the mandates, the tax breaks and the health saving accounts — it’s the debate itself. We shouldn’t be having it.
Before we talk about policy, we have to talk about philosophy. There are people who don’t think that healthcare is a fundamental right and their suppositions are cloaked in ideas of freedom and liberty. They think a man or woman should have the right to choose whether or not he or she is insured. They think the government has no right to force them to pay into a system they might not want, doctors they may not trust and plans that may be lacking. Everyone has the opportunity to sign up, theoretically, but they by no means have to. That’s a fair philosophy. It’s libertarian and it’s easy to subscribe to it if you’re an individualist.
There’s another viewpoint, of course, and that is that healthcare is a fundamental right. If you must insure your car by law, an unfeeling, unthinking machine, you ought to have to insure yourself. These people will readily point out that all men and woman, according the U.S. Constitution, have unhindered access to life, liberty and the pursuit of happiness — and healthcare, to a large degree, promotes and nurtures life and hence we should all have access to it. This access, though, is more realistic than its libertarian counterpart. It’s not an empty opportunity. It is real and of tangible access. It’s subsidized Obamacare and even further, it’s universal healthcare. Government assists because government, in a liberal democracy like the United States, exists to protect fundamental rights.
Before we work out details, we have to address these two huge differences in philosophy. Which is it? Do people have the right to doctors when they’re sick, to affordable medicines, to ever-important maternal care and contraceptives and to therapy and clinical psychologists?
Well, I’m in the opinion that it is. But I’m not the only one. Practically every developed country in the world has universal healthcare because, well, to them it’s a right. But we’re America, right? We’re different. We’re the land of individuality, of choice or freedom. We have never been influenced by what other countries do or believe. In fact, we were founded to get away from the turbulence and customs of Western Europe.
But, even if you look at our ethics, our traditions and our ideals, it’s a right. Every man, woman and child has the right to life, which healthcare preserves, and to fair and equal treatment under the law, which healthcare ensures. We can’t be free and we can’t have liberty if we are sick or, even worse, if we are dead. The healthcare debate is inherently classist whether we want to admit it or not. Poor people are overwhelmingly uninsured and experience more diseases and sickness than rich people who buy their insurance privately or get benefits, like congressmen and women from cushy jobs. When we talk about healthcare, we have to talk about class. And when we talk about class, we are invoking a progressive philosophical tradition that tethers classical American ideas to income equity and social justice.
So, I hope you know, we’re not being socialists or freeloaders when we talk universal healthcare. We’re being American. Healthcare can’t be compartmentalized into policy or its own abstraction; it is freedom. It is liberty. And it is life.
