All I Want for Christmas is Universal Health Care
Every December, radio stations across the country play Christmas songs. In recent years, a song titled “Christmas Shoes” found its way into the rotation. It tells the story of an impoverished child ("His clothes were worn and old, he was dirty from head to toe") standing in line at a store trying to scrape together enough change to buy a pair of shoes for his mother, who is going to die soon from a terminal illness. The boy doesn't have enough money, so the narrator, moved by the boy’s plight, pays for the shoes. Bidding a grateful farewell, the boy rushes to give the shoes to his mother before she passes away, and the narrator muses that God sent the boy to remind him of what Christmas is all about.
The song is hardly controversial. Most people with a conscience would have helped such a boy. Yet when it comes to larger commitments to helping the less fortunate, such as ensuring their access to health care, the controversy of the song’s scenario is clear. The real tragedy of the song, assuming that it is set in contemporary America, is that the boy’s mother probably didn’t have to die an untimely death.
For instance, if we had universal health care, the boy’s mother would have been able to afford yearly doctor visits and preventative screenings that might have caught her illness at an early stage and likely saved her life. Instead, under our current system, the uninsured have no access to health care until things are so bad that they have to go to the emergency room, which in many cases is too late.
Nearly everyone agrees that helping an impoverished child buy one last Christmas gift for his dying mother is a noble task, yet our populous is divided on the question of a system of health care that would work to prevent his mother from dying.
Wouldn't a better Christmas present be a health care system that doesn't abandon people in the first place? Even if conservatives have qualms with the Affordable Care Act (ACA), which they have derisively termed “Obamacare,” one would hope that we all can at least agree that 49 million uninsured Americans is a problem, and that something should be done about it. Yet we continue to hear the same stale arguments against the ACA with no proposed alternative measures to help the uninsured.
Conservatives argue that the ACA’s penalties on companies who do not provide insurance for their employees will hurt small businesses, but companies with fewer than 50 employees do not have to provide insurance under the ACA, and the law will make it easier and cheaper for them if they do choose to provide it.
Conservatives argue that we simply cannot afford the ACA, but the nonpartisan Congressional Budget Committee has determined that repealing it would actually increase the federal budget deficit by over $100 billion. Moreover, under our pre-ACA health care system, we spent more on health care than any other country in the world, and yet the average life expectancy in the United States is shorter than average among members of the Organization for Economic Cooperation and Development, an international economic group comprised of 34 member nations. Conservatives love to say that the government is inefficient, but our for-profit, private sector health care system is substantially more inefficient than most if not all of the so-called "socialist" health care systems used in other wealthy industrialized countries.
This reason for this inefficiency is not difficult to understand. The United States is the only wealthy industrialized country that relies on for-profit health insurance companies to pay for basic health care (T.R. Reid, The Healing of America. The Penguin Press, 2009, pp. 36-37). This reliance inflates our health care costs as a significant portion of our monthly premiums go toward covering the insurers marketing and administrative expenses as well as providing them with a profit. In addition, our medical bills are higher because doctors and hospitals are forced to spend large amounts of money dealing with insurance companies who often do everything they can to avoid paying.
While the health care systems employed by other wealthy industrialized countries may vary in many respects, they have all decided that health insurance must be a non-profit operation. For example, some countries like France, Germany, and Japan employ a system of non-profit funds that cover everybody and are prevented by law from denying a claim or turning people away based on age or preexisting conditions. Other countries, like Great Britain and much of Scandinavia, have single-payer systems in which health care is provided and/or financed by the government (Reid 17-18, 51). The one thing that all of these systems have in common is that they avoid the excessive administrative costs endemic to our private, for-profit insurance system.
If our health care system is the most expensive in the world and yet ignores 49 billion people in need of care, then why, in the recent election, did conservatives not offer their own solutions instead of simply promising to repeal the ACA? One explanation is that the ACA essentially is the conservative approach to universal health care. In 1989, the conservative Heritage Foundation introduced the idea of the individual mandate into modern political discourse as an alternative to the single-payer system favored in Democratic circles. Why do Republicans oppose it now? It may be because they simply don’t want Obama to get credit for it. More likely, however, is that they see the country’s focus on the federal budget deficit as an opportunity to cut government spending on things they don’t like, including popular health care programs like Medicare and Medicaid.
Whatever their motivations, conservatives’ opposition to the ACA has been so intense that proponents have had to spend most of their time defending the proposal rather than explaining the specifics of putting it into action. Indeed, many U.S. citizens are completely unaware that they would qualify for subsidized insurance under the new health care law, which can only work if large numbers of people take advantage of it.
These types of partisan impediments to progress will continue to plague not just the health care system, but also American government in general, unless the American public does something about it. The officials of the minority party will not change their entrenched positions unless it becomes clear to them that the best way for them to win reelection is to recognize and fix America’s health care problems. If their constituents do not explicitly demand cooperation from them, they will not cooperate. Past presidents and congressional leaders know this all too well.
The complete shift in Republican support for the individual mandate is a clear example of classic partisanship, and partisanship is not about governing, it’s about power. We, as constituents, must demand that Democrats and Republicans work together, and we must punish those who make it clear that they are not willing to do so. The American people should send a clear message that they will not vote for any congressman who signs a pledge declaring that he or she will not compromise on tax policy under any circumstances, or who announces that his or her primary goal is to make sure the President does not get reelected. Politicians who value their party’s ideology over the health and welfare of the people they were elected to represent have no place in government in the first place.
The Affordable Care Act may be a step in the right direction, but it’s not perfect and still leaves many Americans without insurance. If we are ever going to fundamentally resolve America’s health care issues, our political leaders must work together. For that to happen, we all will have to agree that, as a matter of principle, every American should have access to basic care, and we are going to have to shift our focus to what works instead of what comports with our party’s ideology.
Only after we, as constituents, make such principled changes will our politicians follow suit. So this holiday season, let’s move past the symptoms and focus on the disease. Instead of buying a dying woman a final pair of Christmas shoes, let’s commit to finding a way to make sure that she lives long enough to improve her situation. Let’s work towards granting all of our fellow citizens access to the health care they need to live fulfilled and happy lives.