WE THE PEOPLE: Article 3: The Need to Promote the General Welfare

Can one honestly speak positively of the country’s general welfare when a significant percentage of its populace lacks good health care? Shouldn’t it then be an important objective to solve that problem and assure that good care is available to all who need it? Note, too, that though insurance is the likely means to provide it, the emphasis must be on care, and not simply coverage.

To address this issue properly, it’s necessary to reach a unanimity of opinion that good health care for all is, indeed, an objective to pursue before there can be any constructive approach to accomplish this goal. For, if one’s ideology is firmly rooted in the prospect that health care is solely an individual responsibility with which the government should not interfere, then there is no need to go further. But based on recent public opinion polls, it is clear that a meaningful majority of the public believes otherwise. And given the cost of health care to the payer (individual or third party), particularly in the case of a major illness or injury, it is not hard to understand why.

Health care costs are strongly age dependent, a fact confirmed by virtually every study on the subject. So, with a rising age population, overall health care costs have risen and one can reasonably expect them to continue to rise. Aside from age, though. overall health care costs have also risen appreciably based on the price charged by health care providers. The bottom line is health care is expensive, and unless you are beyond extremely wealthy, it is and will be difficult for the average person to pay for the medical costs incurred during a lifetime. Thus, the need for insurance.

Whether it’s for a house, a car or health care, the principle of insurance is very easy to understand. By spreading the risk, those who don’t experience a fire in their home or an accident with their car, or those who remain healthy pay for those who suffer a fire, an accident or health issue. Ordinarily, utilizing historical experience, the system stays solvent as long as the pool is big enough to cover the losses, though not in the case of health care. By its very nature, health care insurance is different.

While there is always the exception to the rule, generally the value of a home or car is somewhat related to the income of the insured. The greater the income, the greater the value of a home or car that one can afford. The insurance premium is directly related to the potential value of the loss that might be incurred and the risk that it will. It is, therefore, reasonable to conclude that if one can afford the house or car, he or she can afford the insurance premium.

That is not the case with health care insurance. The medical cost of an illness or injury bears no relationship to the income of the insured—cancer strikes the rich and poor alike. Yet the cost of dealing with any one significant medical intervention can devastate the American household, which had an average annual income of $73,298 for 2014 and a median household income of $56,516 for 2015 (as reported by the U.S. Census Bureau). Keep in mind that the median income represents the amount by which half the population are above and half below. This means that half the U.S. population had (and likely still has) household income below $60,000. It is just not possible for persons in that group, as well as many who fall close to the average income, to pay for the cost of insurance that actually covers medical services. So, when such individuals require medical intervention, they either ignore the need for as long as possible or visit an emergency room for treatment.

If one believes that a healthy population is necessary for the general welfare of the country, then there must be a national program in place to provide the care for those who cannot afford it.

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