Pull the trigger

In his speech Wednesday night, President Obama delivered a vague catalog of possible health care reforms before saying, “Even if we provide these affordable options, there may be those ... who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers. The problem is, such irresponsible behavior costs all the rest of us money.” Actually, the problem is that those uninsured people could instantly become impoverished by an illness. The moral issue of human health is still being confronted on the basis of a monetary cost-benefit analysis, with full faith placed in the market’s ability to provide adequate care. Republicans especially suggest that the health insurance companies just need a little push in the right direction (exemplified by the “trigger” option), and from there, those companies will provide more Americans with cheaper health care than the government could. Never have conservatives’ odes to market forces seemed more delusional than now, as the market’s unregulated force sweeps the country into a historic recession. But many elected Democrats are right there with them.

Policy choices must be paid for responsibly, but let’s consider how we think about price tags in this country. Legislators have political cover to spend indiscriminately on defense because they agree that security is too fundamental to our well-being to quibble about cost. Currently, the health of our citizenry is held to a lower standard, despite the fact that the lack of long-term care could kill an uninsured American as easily as a bomb. We might ask with philosopher L.T. Hobhouse, “Should sick people be treated according to their illnesses or according to their status in labor markets?” It goes without saying that our current market-based system has chosen the latter, making health care a privilege of affluence.

A new cost-benefit analysis is required of us now. Isn’t the economy supposed to support our life, liberty, and happiness, not the other way around? Critics of the “public plan” pretend that we would be trading prosperity and efficient health care for poorly administered government handouts. But we have solvent examples of both single payer (the VA) and publicly funded (Medicare) health care. This Reaganomic tunnel vision must be replaced with a philosophy that considers markets one of many tools to achieve the social good that we desire.
Conservative members of Congress have tied their tongues in knots trying to seem compassionate while arguing that the government should not guarantee care. The current rhetorical gymnastics recall the 2007 fight over the State Children’s Health Insurance Program (SCHIP), a wildly successful federal program to insure impoverished children. Then, the New York Times reported that “Republican opponents of the bill … said it would be a big step toward socialized medicine, would shift people from private insurance to a public program and would allow coverage for illegal immigrants and children in high-income families.” Since SCHIP didn’t force anyone from a private to a public plan, it could only “shift people from private insurance” by providing a superior alternative. And what could be wrong with that, except its betrayal of free-market philosophy?

Alas, Obama’s most publicized comment on the issue was his tepid criticism of Republican slams being “not logical.” Wednesday’s speech even heralded the coming of “a new insurance exchange—a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.” Why, more free enterprise—just what we’ve been missing! Obama continued, “Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.” We can all rejoice in the news that insurance companies will not be oppressed by the president’s plan.

The president has failed to reframe health care reform. Perhaps instead of celebrating “our self-reliance, our rugged individualism, our fierce defense of freedom, and our healthy skepticism of government,” Obama might emphasize the communal obligation of citizens to make sure that none of their own are ruthlessly exploited. Advocates of real change have watched Republican spin doctors control the dialogue since last spring, forcing the national conversation toward such absurdities as “death panels.”
So as conservatives struggle to reconcile their ideology with a country of uninsured citizens, government can facilitate our collective responsibility to one another. The question is whether Americans who came of age in the era of Reaganomics can accept that health care, like defense and good roads and clean water, is a national need worthy of increased progressive taxation. Then, perhaps we can start treating people according to their diseases, not their incomes.

Sarah Leonard is a Columbia College senior majoring in history. Kate Redburn is a Columbia College senior majoring in history and African studies. Shock and Awe runs alternate Fridays. opinion@columbiaspectator.com