The sad, selfish argument against healthcare

Senate GOP Healthcare bill

In the current debate over Republican efforts to repeal the Affordable Care Act, one of the saddest arguments to be heard is the one that goes, “why should I pay for someone else’s healthcare?” Such an argument gets many things wrong at once, both intellectually and morally.

First, the entire concept of insurance is a pooling of funds and risk, so that everyone is literally paying for someone else, and vice versa. For example, in South Florida, one is told that car insurance rates are high for all residents because there are many claims due to the large number of tourists getting into trouble with rental cars on unfamiliar roads. Many local residents would rightfully object to paying higher rates for others’ accidents, but that is how insurance works. The idea, however, is that costs are kept down by pooling the risk, for example, such that middle-aged drivers might pay more than they get back in claims, but when they are both very young and very old, they are much more likely to have more claims, so the system balances out. Similarly, the Affordable Care Act (based on a conservative idea from the Heritage Foundation and first implemented by Republican Governor Mitt Romney in Massachusetts) incorporates premiums paid by younger people, who generally have fewer claims, going more to older and sicker people, but such young people of course could get into a serious accident or become sick themselves any time, plus they are likely to have more claims as they age. Thus, the idea of “why am I paying for someone else?” may only be true for a brief moment.

Second, many government programs also work this way, including Social Security and Medicare. In those two programs, which are among the most popular and successful programs in U.S. history, younger people pay for the care of older people, and when those younger people get older, they have their services paid for by the then-younger people at that time. Sadly, the arguments against the Affordable Care Act today would be the same arguments made against Social Security and Medicare if those programs were proposed today. Being for or against such programs is now a good marker of whether one is a Democrat (“we’re in this together”) or Republican (“you’re on your own), although, hypocritically, many of those same Republicans are older voters who are more than happy to take their Medicare and Social Security today.

Third, the way the Affordable Care Act works — pooling together resources so that people literally pay for services rendered to others — is the way government works generally. For example, during George W. Bush‘s presidency, he spent tons of our taxpayer money on his ill-fated Iraq War, and also spent taxpayer money on things like the “Faith-Based Initiative,” giving our money to church organizations (many of them part of the Republican political base). Similar to the Affordable Care Act, voters who opposed such measures still had to pay for them, because they were implemented for the whole country. We don’t get to choose our government a la carte.

The one backstop against government programs we don’t like is, of course, the voting booth. In America, we have elections for representatives such as members of the U.S. House and U.S. Senate, as well as for presidents who represent the whole nation, and more local officials such as state house members and state senators. If we don’t like laws such as the Affordable Care Act, or executive orders like the Faith-Based Initiative, or costly jet trips by Trump officials and their wives that end up causing us to “pay for others,” then we can try to elect representatives who will vote and act more our way.

Photo by Mike Licht, used under Creative Commons license. https://is.gd/l7W6Uk

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