What’s wrong about health care for all?

What’s wrong about health care for all? This question crossed my mind last week when I learnt that the constitutionality of President Barak Obama’s health care reform (commonly known as ‘Obamacare‘) is being contested. The ruling of the US Supreme Court on this may turn out decisive in the presidential elections to be held on November 6th. Here is some background.

Expectations towards the first US president of Afro-american origin were stratospheric when Obama won his first term. The promise for change was written all over his campaign. And indeed change was in the air when he took office about 3 years ago. Many expectations have since been disappointed (we think of Guantanamo Bay, the embargo against Cuba, financial regulations, the conflict(s) in the Middle East etc.) The achievement which is regarded by many as the legacy of his presidency is the overhaul of health care provisions in the US. Obama managed to extend health care coverage to almost all American citizens (something that a number of his predecessors attempted but failed to do during the last 70 years). This has now been called into question. What are we to make of this?

The Washington Post for instance had an article (see also the comments) that throw a bit of light on this matter:

Central to the dispute over the law is a provision that requires individuals to have health insurance by 2014 or pay a penalty. Polls show that this mandate is opposed by 3 of 5 Americans..()

“A lot of the arguments that are being made against it right now are that they violate basic constitutional rights and principles,” said Tad Devine, a veteran consultant of Democratic presidential politics..()

The question is not whether health care coverage for all is a good or a bad idea. The question is rather: Can the state force its citizens to sign up for something (in this case a health care system that benefits millions of ordinary Americans) by threat of penalties if the citizens do not comply? Is this a violation of basic constitutional rights and principles (such as individual freedom)? 60 percent of Americans seem to be of this view.

Here one realises that the societies in Europe and the USA are based on different principles. What Europeans would consider a technicality is of fundamental importance to Americans.

Most Europeans are prepared to compromise on their individual freedom in order to built a fairer society (all social welfare schemes are based on shared responsibility). Yes, there is a certain level of compulsion since a functioning welfare system can only work if properly funded. A possibility to opt out would be considered anti-social.

In the US by contrast the community takes second place to the individual even on this important issue. We must keep in mind that many immigrants came to the US in pursuit of their individual ambitions and their freedom. So every law that has the potential however remote of breaching this principle, will encounter fierce opposition, specially during an election year.

So is this the end of it? No. In my view voters do see the reasoning behind this bill. Politicians who are worth a penny should be able to save this historic piece of legislation by addressing the constitutional concerns. This can be done. This should be done.

For further reading on the US health care system see the following link. It was written back in 2008 before Obama was inaugurated. It’s nonetheless very informative. Article

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