Give Me Liberty, Which Includes Health Care
A progressive vision for health care in the 21st century
In his seminal work, Common Sense, Thomas Paine establishes that a government’s right to exist is contingent upon its ability to protect its citizens’ life, liberty, and property (sure, Jefferson may have decided that “pursuit of happiness” had a better ring to it, but this is a capitalist system; are you really surprised that Paine said “property” instead?).
In our modern world, we must understand that the right to life includes the right to a life of decent quality through health care for all — not just those wealthy enough to afford coverage. In the Constitution, the Founders established that a primary imperative of the government is to “promote the general Welfare.” The American Heritage Dictionary defines welfare as “health, happiness, and good fortune; well-being.” Doesn’t the government violate this imperative when it subjects the health of its citizens to a market whose responsibility is not to its consumers, but to its shareholders? The market may generally respond to the demands of consumers, but when it comes to health care, consumer demand is driven not by traditional free-market discretion, but instead by accidents, injuries, and diseases coupled with physical, financial, and emotional duress. Since the demand for health services is not strictly consumer originated, the free-market approach gives providers and insurers an automatic upper hand in bartering, leaving the consumer with little real choice or freedom.
Even if we set aside the fact that nearly every other industrialized nation provides health care to its citizens, our own Founders set up a system that not only allows, but mandates, us to do so in this country. The Founders constructed a government that allowed for lapses in their own knowledge to be corrected by subsequent generations; for example, James Madison couldn’t have conceived of future advances in medical technology, but introduced universal measures by which the government could accommodate such evolution. This faith in future generations, however, has not been rewarded; our government does not share the Founders’ commitment to upholding our “unalienable rights” to life, liberty, and the pursuit of happiness. The GOP’s paternalistic exhortation to purchase prohibitively expensive private healthcare plans masquerades as a guarantee of the “freedom to choose,” but Paul Ryan’s much-touted “access” to health care is simply not enough: the right to purchase health care does not provide the means by which to obtain it. In this respect, even the ACA did not go far enough; it failed to provide a public option that would ensure that all citizens receive health insurance.
We must ensure that all Americans have insurance. What liberty exists in permitting citizens to die as a result of a flawed healthcare system? How can the “pursuit of happiness” be ensured when a catastrophic event can drive you to bankruptcy, forestalling the pursuit of even basic necessities? Are property rights protected when the government permits debt collection agencies to take the homes of those who default on their mortgages because of unexpected medical expenses? How can the government claim to protect the right to life when it professes to grant security from external dangers such as terrorism, but simultaneously refuses to protect its citizens from internal threats related to public health? What is freedom supposed to mean when your “freedom of choice” is either to die impoverished at the hands of companies that value a dollar more than your life, or to hope that you know enough wealthy people to “gofundme” your way back to health? Do the impoverished in the richest country in the world not have the same right to protection of life, liberty, property, and the pursuit of happiness as their rich counterparts? Is it acceptable that our poorest citizens languish under the despotism of a capitalistic empire that considers their lives unworthy of protection from disease?
The government only has a legitimate right to exist if it fulfills the promises set forth in the Constitution — to promote the general Welfare — and the Declaration — to protect life, liberty, and the pursuit of happiness. We fought for these ideals; we shouldn’t settle for less, and in abdicating its responsibility to provide health care to its citizens, the government abnegates its legitimate right to exist. As such, it is a government of the people and by the people, but no longer for the people. This, as Jefferson would remind us, is tantamount to a cause for revolution: “But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.”
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