Health insurance is a moral right
An appeal to the incoming Congress
If Thomas Jefferson were writing the Declaration of Independence today, the “unalienable” rights of life, liberty, and the pursuit of happiness that are to be secured by government would include access to medical care.
Unalienable — or inalienable — does not mean free. However, it does mean that all citizens can obtain preventive care to maintain good health and treatment for chronic or catastrophic illness.
While many Americans have the financial ability to pay for an annual physical or an occasional visit to the doctor when a cold won’t seem to go away, how many Americans can cover the cost of open heart surgery, radiation or chemo treatments for cancer, a hip replacement, or a series of high-tech diagnostic tests that are now so common? Even the infamous $600 EpiPen is a financial burden for many.
No American will live life without needing a major medical intervention, the cost of which would devastate the financial health of a family.
That’s why we have health insurance.
The theory of health insurance
The idea for health insurance is straightforward: we pay an affordable monthly premium so that when serious illness occurs — and it will — we can access the best treatment to cure or ameliorate the condition.
Health insurance is sustainable when the contributions from all the healthy people are greater than the costs of treating those who are ill.
In addition to paying medical costs, any health insurance system will have administrative expenses that must be covered by the premiums. Where the insurers are for-profit corporations, the stockholders expect the company to consistently generate profits. After all, many stockholders are investing to build future retirement income, so the insurance companies’ profits must be covered by the premiums.
To be consistently profitable, insurance companies seek to reduce their costs and any risk that costs will increase. That’s why they excluded pre-existing conditions and set lifetime maximum payments before the Affordable Care Act (ACA) became law. The insurance companies have a fiduciary obligation to serve their shareholders first, not the patients or their doctors.
According to the Kaiser Family Foundation, in 2015 about half of the U.S. population obtained health insurance through their employers. Most substantial companies offer health plans that, rising premiums notwithstanding, protect employees from the financial ruin of a serious illness. The employers share the cost of health insurance with their employees, usually paying 75 percent or more of the premiums. That works well until someone loses his or her job and must pay the full cost of the insurance to continue coverage. Just as income drops to zero, the cost of insurance jumps 4x or more.
With many small companies not offering health insurance, the cost of private insurance plans prior to the ACA was unaffordable for many, assuming they weren’t denied because of a pre-existing condition.
The Affordable Care Act
The goal of the ACA was to make affordable health insurance available to Americans who didn’t have coverage and reduce the number of citizens without insurance. Insurance coverage through the ACA would enable people to seek timely medical care and virtually eliminate the risk that a serious illness would devastate their financial security.
These worthy objectives became lost in the political process, with the ACA passed by the Democrats in Congress over the strong objections of the Republicans. Since passage, the Republican mantra has been to repeal the ACA, despite its success in reducing the number of Americans without insurance. Now, with a Republican administration and Republican-controlled Congress, the Congress is planning to start down this path, even before President-elect Trump takes office.
Although some Republicans have discussed the need to “repeal and replace,” there are few details about what will replace the ACA. The emotional energy is for repeal. It’s like blindfolded children swinging at a piñata, where the piñata is the ACA. Speaking before the Heritage Foundation on December 6, 2016, Vice President-elect Mike Pence discussed the priorities of the new administration, saying,
We’re going to start out by repealing Obamacare, starting the process of replacing it with free market solutions.
Repeal and start the process of replacing the ACA. I don’t have much confidence that those words convey a strong commitment to ensuring all Americans have access to affordable health insurance.
A moral right
Which brings us back to my tenet that access to health care and affordable health insurance to ensure that access are rights of all Americans. In the 21st century, both are integral to life, liberty, and the pursuit of happiness.
That’s the moral imperative and measure of success that should guide the Republican Congress and Trump administration as they fashion their “better” free market solution. I truly hope their actions will be motivated by the desire to serve the people, not simply repudiating President Obama.
