The debate about the Affordable Care Act, the attempt to repeal and/or replace it, is an invitation to examine the core values embedded in the various assumptions of the discourse.
Three values that have become apparent are: the primacy of financial considerations, an individual’s freedom and the right to health care for every human being.
Financial implications, for example were emphasized in a March 13 White House email proclaiming, “Americans were promised that Obamacare would bring down health care costs. … Americans were promised that Obamacare would not raise taxes on the middle class.”
Sen. Rand Paul said on Face the Nation, “We’re not going to vote for it (Ryan’s plan)” because it creates a system of refundable tax credits. In addition, the recently released Congressional Budget Office analysis focused on costs of insurance premiums and federal deficit reduction.
Rep. Paul Ryan, speaking on CBS’s Face the Nation on March 12 advocated for the primacy of the value of an individual’s freedom. He seeks to eliminate any mandate on individuals to buy insurance, saying, “People are going to do what they want to do with their lives because we believe in individual freedom in this country.” He proposes a plan where people are free to buy insurance in the private market.
Also, National Public Radio interviews with people who are critical of ACA reveal a positive attitude toward acquiring health insurance but a resistance to any “mandate” telling them they must have it.
The problem with being guided by the primacy of economic considerations is that it traps us in a debate about the value of a healthy human being and which of us has earned the right to be healthy.
Adhering to the mantra of “individual freedom” leads us into a society where every person must fend for himself or herself. Both of these approaches are divisive and contrary to the vision of freedom and justice for all. They ignore the reality that we’re all in this together. The freedom and health of each individual affects the freedom and health of our communities and nation.
However, there is a value that can serve us well in the debate about health care in our country.
Rep. Annie Kuster, in a March 10 email, suggested valuing the importance of health care for every human being. She wrote, “I am ready to get to work to … find ways to help improve health care for every citizen.”
Logically, extending her focus on improving health care for every citizen invites us to begin a serious discussion by first seeking agreement to value good health for all human beings, no matter who they are, their economic situation or where they live.
Some cynics will suggest that it is the nature of human beings to focus on individual and family fortune. For example, in the current debate of the ACA, some healthy young people say, “I don’t need health insurance, so why should I pay for the coverage of those who are unhealthy?”
However, there is another side of human nature that may be worth cultivating. Consider the times and situations that bring out empathy and care for others. How often have we observed the ways people rally after a natural disaster or a tragedy in the life of an individual, a family or a community?
People are energized and heartened as stories are told about volunteers contributing their time, skills and money to support victims. People celebrate these situations as evidence that human beings are really good people supportive of their neighbors.
It seems that in times of crisis, the glorification of rugged individualism is subverted. The people of our country have a history of standing with each other.
In the early years, it took a village to raise a barn. Not so long ago, neighbors would help one another get the hay in before a thunderstorm descended.
It is time to refocus a health care debate that has been based on personal economics and individual freedom values to the basic value of communal support for every person in our society.
The many stories and examples of empathy and commitments to helping others in need can contribute to this discussion.
In the course of the conversation, the evolving nature of the human condition may surface. Could it be that rugged individualistic self-interest is giving way to communal concern? The task for elected officials and the American people will be to embrace this new possibility.
With this groundwork, the means of developing a health care system of economics that shares wealth and benefits and a society that recognizes freedom to be supportive of one another will begin to fall into place.
To return to the barn-raising example, once we agree that a barn is needed to shelter a given number of animals and store a given amount of hay, the details of the shape and size of the barn will soon be resolved.
In the same way, when we agree we are together responsible to provide adequate health care for all people, the economics to make it happen will take shape.
It will be a triumph for our basic cooperative human nature working for a greater America.
(John Buttrick lives in Concord.)