Many argue that healthcare should not be an entitlement. Rather, Americans must be self-reliant citizens and provide for their own healthcare beyond the purview of the federal government. But the cost of medical care compared to the average and median American household income makes that an unrealistic possibility. And there is another reason – what we expect from our citizenry, and what we owe in return.
The Citizenship Resource Center in the U.S. Department of Homeland Security outlines Citizenship Rights and Responsibilities. Intended primarily for those interested in becoming citizens of the United States, they are, of course, applicable to those who already have that status. Respect of the law and the rights of others, payment of taxes, serving on a jury, participation in the democratic process and defending the country should the need arise are among them.
In general, regardless of one’s health, a citizen can meet his or her responsibilities except the last—to defend the country. So, on the one hand, we ask that a citizen be prepared to give up his or her life in defense of the country, but on the other, see no need to assure that individual has appropriate healthcare to do just that. And what is worse, look at the life that individual must endure if, indeed, he or she is called or volunteers to serve and is badly wounded in combat.
There is a phrase in the French language, “en principe,” which translates to “in principle” and is understood to mean: that’s the way it’s supposed to be, but the reality is quite different. For example, in principle, French trains always run on time. We don’t use that phrase as much in the same way in the United States, but we might as well when it comes to the care veterans receive, returning home from combat. If the system functioned as it should, there would be no need for organizations such as the Wounded Warrior Project or Disabled American Veterans to provide what the government does not. So, while we profess to take care of our veterans, the reality is something else. And that’s just healthcare, not other issues facing returning veterans like employment or homelessness.
But it’s not just veterans whose healthcare is at issue. When it comes to defending our country from outside threats, the mantra is “we must all stick together,” but assuring the health of that same “we,” is an individual issue. Your problem—deal with it! There’s something not right about this.
Yet there are legitimate concerns about the overall cost of a universal healthcare plan and whether such a plan with a growing expansion of Medicaid spending can be sustained. But the answer is not eliminating certain provisions of the existing Affordable Care Act (Obamacare), principally to reduce cost or eliminate unpopular regulations while leaving millions of Americans without vital healthcare protection.
So we must return to where we began this discussion. If there is no unanimity on the question of whether good healthcare for all is an objective to pursue, then we are doomed to an inefficient and costly patchwork of provisions and regulations that will not provide care to all who need it. Or, if we can agree on the objective and replace ideology with reality, there is an opportunity to accomplish that goal with a new comprehensive plan at a sustainable cost level.