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Who deserves health care?


Is there someone you think should not be able to see a doctor?  The new proposal hopes to improve access with the exception of 45 million or so (American exceptionalism?), who can’t or won’t afford it. It is a question we must answer according to our humanity rather than political affiliation, ideology, or income level.  We need to ask instead how we’ve decided that some Americans don’t deserve health care.

Almost all other industrialized nations pay much less to provide universal health care. They have made a conscious decision that a healthy citizenry makes a healthy nation.  Should I care about your health?  Should you care about mine?  In most other countries the answer is a compassionate and fiscally pragmatic, “yes.”

Now there is a push to repeal the Affordable Care Act  and put in place a system that would reduce the number of insured by 24 million and increase premiums by 15-20 percent in 2018-2019.  The selling point is a reduction of $337 billion in costs over 10 years, that reduction delivered by less “customers” served, paying higher premiums.    

House Speaker Paul Ryan on the CBO analysis: “This report confirms that the American Health Care Act will provide massive tax relief, dramatically reduce the deficit and make the most fundamental entitlement reform in more than a generation.”

He neglected to mention for whom tax relief is massive, or that the deficit is reduced in proportion to the numbers of Americans denied health care.

Many of the 24 million no longer insured will be those simply willing to gamble on their continued good health, or no longer able to afford the increased premiums.  They are free to make that decision because there is no longer a penalty for going without coverage. With fewer young, healthy enrollees, insurance companies may be less willing to offer coverage plans if the sick and the elderly are not seen as a profitable customer base.

The idea that competition will lower costs and provide better plans seems patently silly.  Instead it has given us the $650 Epipen and Martin Shkreli, who raised the price of Daraprim from $13.50 to $750.00 overnight. Leaving health care to the tender mercies of insurance companies and the pharmaceutical industry has given us the highest per capita costs in the world.

This is our decision to make: Should American health care policy be designed for the benefit of the sick and injured or the benefit of for-profit providers?    

I care about the health of my family.  I even care a little about the health of those on Pettygrove Court.  Should I also care about the health of those on Dearborn Ave.?  Wheatland Rd.?  Maybe I should care about the health of everyone in Oregon.  It may be a failure of mine if a kid in inner-city Chicago ends up in the emergency room for lack of routine wellness care.  To paraphrase just a tiny bit, “Truly I tell you whatever care you provided for the least of these brothers and sisters of mine, you did for me.”

Medical care has been around since biblical times. Is it now a business opportunity?  Though we allow it a major stake in our decisions, health insurance as a for-profit industry hardly even existed before World War II. One of its principal effects has been to drive low income Americans to the very costly services of hospital emergency rooms. Is there no more humane way to provide health care for all?

(Don Vowell gets on his soapbox regularly in the Keizertimes.)