There are some things that our society has agreed are to be regulated, with government control and measures in place. Electricity, drinking water, and the radio spectrum come to mind.
With the current “plan” put forward by the Republican Party, there are fewer people covered, tax breaks for the wealthy and a number of other issues that take away from the larger issue we have to address as a country. The Affordable Care Act aka Obamacare was seen as a boon to the poor or nefarious government overreach, depending on your political and philosophical point of view.
The big question to settle is this. Is Healthcare as important to our national infrastructure as a regulated electrical infrastructure? As the federal highway system? As food that is safe to eat? As national defense? If it is, we should treat it as such. If not, then don’t worry about any of this. We just live or die with the consequences of our collective indifference.
If it as important as the staples of power, water and the like, we have to look at not the coverage gap, but rather, we have to start with the idea that everyone who is a citizen of the United States deserves health care. Oddly, we are already in agreement. What we can’t seem to agree on is how that happens, tax credits? Federal programs like Medicare and Medicaid are both government-sponsored programs designed to help cover healthcare costs. While both were established by the U.S. government in 1965 and are taxpayer funded, they are actually very different programs. In the most basic sense, Medicare is designed to help with long-term care for the elderly, while Medicaid covers healthcare costs for the poor, but there is much more to it than this.
So, the majority of us decided then and now, that “assistance” is something that we agree on. That implies that health care is really important to us a society and that it can be too expensive for some of us. But unlike many of the other things we consider to be fundamental to our society we don’t, to any significant degree at all, have governmental cost controls in place. For most of us, if our local utility company wants to raise the price of a kilowatt hour of electricity, they have to provide and rationale and present that to a committee of private and government officials. There is not guarantee of the rate increase. On the other hand, Insurance companies can change rates for any reason whatsoever. Aetna, who claimed that the ACA was ruinous for them posted a Full-year 2016 net income was $2.3 billion. Drug companies can have fantastically higher prices of their drugs in the US as opposed to other countries. Merck, a US-based drug company made over 2.1 billion in the same time frame.
The political and ideological dilemma is the same. We are talking about regulating a huge section (measured in dollars) of the free market. We are talking about interfering with the capitalist fundamentals on which we built our nation. That isn’t really up for debate. That is what we are talking about in this article. How much profit is too much? How much influence is too much? Should be protected from predatory practices? That’s such an amazingly loaded set of questions, fraught with implication and many points for debate. It is a question we have asked ourselves as a nation before and I encourage us to ask again.