Debate of the repeal/replacement of Obamacare has prompted
a discussion again, seven years later, of whether everyone should have health
insurance.
Remember the claimed dire need to provide such insurance
for the twenty million or so Americans without such coverage? That was the catalyst for the so-called
Affordable Care Act.
Yet the reality was that millions of that number didn’t
want it, as was recognized by Obamacare architects. Thus, the health care mandated universal
coverage under pain of penalty for those who resisted. In that sense, having health insurance became
an obligation. But the focus on
insurance obscured the underlying – and real – policy: the presumed right to healthcare. After all, having health insurance, as such,
cures and prevents nothing. It merely
provides a means of access to medical care.
[Leave aside for another time, consideration of Obamacare’s
stark deficiencies, with its high deductibles and restricted options.]
However, as a matter of fact, not widely known, all
Americans and those who are not have long been able to go to essentially any
hospital ER and receive emergency treatment, at least, whether they have
insurance or not. Indeed, those treated
will be billed, often at outlandish rates, with the hospital recognizing that
payment of the amount due is often not to be expected. The facilities, nonetheless, are required to
provide necessary medical services.
Does this reality mean that the recipient of what may be “free”
care and treatment has a right to it?
No. In the same sense
that a person receiving welfare such as food stamps does not have a right to
those benefits. Of course, society may
establish criteria by which a person may qualify to receive benefits, but it’s
hardly a right in the way we all may utilize the First Amendment.
The opportunity to receive something from society in the
manner of generosity is fundamentally different from the right to do something
as in the free exercise of one’s religion.
The former, as with any gift, may be withheld in the future. It is, in fact, only a conditional
right. Constitutional protections are
permanent.
Still, in practice, both concepts do involve
entitlements. Free speech is obvious
while healthcare is a mandated right in the sense restricted to those who – for
the lack of a better characterization – are poor.
In the American system, therefore, the right to healthcare
is dependent on one’s economic status – the conditional nature of the
entitlement. Plainly, the right
presently does not exist for most.
Those on the left would differ with this approach and
propose that the entitlement is for all:
the old fashioned term for what they have in mind is socialized
medicine.
A note on bipartisan economic folly: One of the more popular features of Obamacare
is the provision of insurance coverage for those with pre-existing
conditions. Recognizing its popularity,
the GOP’s replacement plan incorporates such coverage.
That is bad policy which means higher premiums for everyone
else without such problems.
Consider how an automobile insurance company would react if
you called up and said you needed collision coverage for your car but wanted
coverage to begin two days ago because your vehicle had been in an accident
yesterday.