Opinion

Consider all the repercussions

Democrat-leaning voters like me were galvanized by last month’s passage of the AHCA in the House; soon the Senate will take it up. But in any case, America needs to think deeply about the whole issue.

My conservative friends say we have no “right” to health care as it’s not in the Constitution. And they are correct, but then again, neither do we have any right to public roads under the 1787 concept of the Constitution, or federal control of airspace, or public education, or any of the protective bureaus created in the eras of Theodore and Franklin Roosevelt.

The “Freedom” Caucus of Tea Party Republicans wants a laissez-faire economy. They are mostly well-to-do if not wealthy people who just want to enjoy the benefits of a rich country without ever having to share or shoulder any responsibility to others. Stop listening to them! What they really believe is laissez-mourir...let them die!

We have, in the 50 or so years since Medicare and Medicaid began under John Kennedy (who proposed it) and Lyndon Johnson (who secured passage), greatly increased the lifespan of most of our people. Having opposed both, I have changed mainly because I see that the “free” market we all believed in so deeply — and that works just fine for most consumer goods — does not work equitably or with meaningful progress, in the field of health care. Medicare and Medicaid government money, as well as government-funded NIH research and university-sponsored research have made the greatest difference in outcomes in the half-century of American life since 1965, in heart disease, cancer care, care for the elderly and so on. Meanwhile modern technology has made the difference in outcomes between those with access to comprehensive health care and those without, far greater.

Thanks to all this investment, we have an enormous health care industry consuming, as I understand it, between a sixth and a fifth of the entire economy (GDP). It continued to expand under Obamacare as more people than ever before were covered by decent policies. Almost every county in America has at least one substantial hospital with emergency service and staffing, MRI equipment, intensive care and so on. It comes at a stupendous cost — trillions of dollars each year. It’s a colossal infrastructure. Do we want to keep it functioning or not?

Would you, conservative Americans, really like to see huge amounts (estimated $800 billion over 10 years) taken away from Medicaid? Who else would fund all these hospitals? For example: Do you want local hospitals to have enough funds to take in those who, without insurance, have no place to turn except emergency rooms when they or their children get hurt or sick? Some conservatives are consistent enough to say no, that since there is no “right” to health care, emergency rooms and all doctors and hospitals should have the right to turn away the poor, who can’t pay and have no insurance. Is that what you want, people actually dying for lack of care? Laissez mourir! I’m sure you think that charity, volunteers and the “free market” would take up the slack. This is a fantasy. We would find ourselves back where we were before 1965, with well-to-do people able to find care, with less funding for research and with poor people, and elderly people whose money runs out, simply dying younger. Very many nursing or rehab homes would run out of money and close. Old people might or might not be able to live with relatives who would be able to care for them. Is that what you want? Might it not be your local hospital that will be forced to close or cut off care to someone you love?

If that is what you want, conservatives, especially those of you who call yourselves Christian conservatives, you need to read again the teachings of Jesus Christ. If it’s not what you want, you should find it in your heart to support a continued, expansive federal role in health care. I would like to see that culminate in a single-payer system, such as Germany and Australia (which Trump seems inadvertently to have complimented) have. There would be growing pains and tax grumbling. However, businesses freed from health benefits might be more prosperous than ever. The alternative is not cheaper; it is more costly in terms of lost health, early death and the kind of low-grade civil war that we seem to be heading for, between haves and have-nots.

Steven Smith is a resident of Houserville.

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