Wolf Blitzer put a terrific question to Rep. Ron Paul in a Republican Presidential debate in Tampa, Florida last September. What should happen, the moderator asked hypothetically, if a healthy 30-year-old man who can afford health insurance chooses not to buy it, and then becomes catastrophically ill and needs intensive care for six months? When Dr. Paul ducked, fondly recalling the good old days before Medicare and saying that we should all take responsibility for ourselves, Blitzer pressed the point. “But, Congressman, are you saying the society should just let him die?” At that point, the Tea Party rabble in the audience erupted in cheers and whoops of “Yeah!”
Paul never answered the question directly, saying only that private charities would take care of him, an obvious evasion of the question. Government cannot rely on private charities to provide essential services. Those charities have no legal obligation to do anything.
Republicans do not want universal health care for all citizens. They want private, for profit health care at whatever price the providers conspire to charge. Do you really think health care is a competitive market? Do you also believe that oil companies are in head-to-head competition on gasoline prices? Do you also believe in the Easter Bunny and Santa Claus?
The reality of the healthcare question is, of course, much more nuanced. Not every person who does not have insurance has the money to buy it. For many, it is a choice between food and rent or insurance. For the homeless, it is even further out of reach. What do Republicans think should happen to people who simply cannot come up with the money for premiums? Do we just let them die in the streets?
The response of the crowd at that debate was an indication of the gulf that is growing in this country between the “personal responsibility” mantra from the Right and the “social responsibility” of the Left. Social Darwinism vs. the welfare state. The key word here is responsibility. If you are a failure in life, whose fault is it?
Why didn’t the Roman Mob screaming for the man’s death as if he were a defeated gladiator consider alternatives, like suggesting that his life should be saved, and then he should be presented with the bill? Of course, that raises many questions: What if he was incapable of signing a document of financial responsibility for the treatment? Would it be considered coercion to ask a deathly ill person to sign a form acknowledging responsibility for treatment to save his life? Could he be held responsible for such a bill? What if the bill was so huge that he could never pay it off, and declared bankruptcy?
What happens to such a person today? President Ronald Reagan signed a bill in 1986 requiring emergency rooms to treat the urgently ill regardless of their ability to pay. The costs of emergency rooms are passed on to taxpayers and purchasers of healthcare insurance. A 2009 study estimated the cost of paying for the uninsured at $1100 per insured family.
People make mistakes. People do foolish things. Sometimes people are unable to do the prudent things that protect them from disaster. What should the rest of us, the Responsible Majority, do about them? When do we have a responsibility to save them from their errors or misfortune?
Every case is different. It is naively simplistic to try to apply a “one size fits all” solution to this problem. What about mentally impaired individuals? Substance abusers (including smokers)? The chronically unemployed? The homeless? People on welfare? And yes, the “refuseniks” who just decided to take a chance?
The growing economic divide in this country is making this problem worse, as more and more people fall below the poverty line. Helping and encouraging those people to find jobs so they can support themselves would greatly lessen this problem, but the current economic mess may last for many years. The last number I heard was fifty million. Fifty million people with no healthcare insurance. That’s about one-sixth of our population.
Which ones do we save, which do we let die? Who should make the decision?
Personally, I find it distressing that we are even having this discussion. Many nations have universal medical care for all their citizens. I think it is a national disgrace that we do not have such a program. We are already paying for it to a great extent, through the passed-on costs of emergency room treatments. That helps some people, but not all.
To those who deplore the moral decline of America, I say…if you are willing to let a single citizen die because they cannot pay for healthcare, you are part of the problem. Ask yourself: What would Jesus do?
There is plenty of money in this country to solve this problem. It’s just in the wrong hands.