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Healthcare is as much an issue of health and survival as it is an issue of economic security and freedom. Survival has always depended upon the ability of people to find sufficient water, food, and shelter, but modern society has shielded the citizens of developed countries from the harshness of nature and made survival dependent on the ability to access and participate in the modern economy. The greatest benefit of modern society is the ability of individuals to move beyond the daily struggle of survival to an existence in which personal wellbeing and comfort become the focus of life. To benefit from modern society, however, people must be able to access modern amenities like healthcare.
A lack of healthcare can kill. In terms of survival, a lack of access to healthcare can mean death in the face of a random accident or illness while a lack of regular healthcare is likely to result in a shorter lifespan. Because most people rely on health insurance to make healthcare affordable, public policy shifts that impact either healthcare or health insurance industries determine whether people can access quality healthcare on a regular basis. For people whose socioeconomic standing make healthcare an unaffordable luxury, their health and financial wellbeing are at risk. Given employers and government provide health insurance for the majority of the insured, a lack of insurance can also translate into income inequality as well as a lack of economic security and freedom.
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Government is a service. For modern governments, which exist solely to serve the interests of the People governed, government is a service provider that is held accountable via civic engagement. The primary service government provides is the management of civil infrastructure, communal assets, and public works. Government, at all levels, organizes society, so communities of all sizes can function properly. Unresponsive and inept government has frustrated a number of people to the point they no longer see the benefit of government, but a community without some form of government, which is somewhat functional, cannot function as a community. Functional and responsive government is needed.
Like any service provider, however, government should practice good customer service. Whether a billionaire paying millions in taxes or a welfare recipient receiving a few hundred dollars in public assistance, whether a corporation facing a regulator or a driver renewing a license, whether a senior citizen applying for Social Security or an average citizen mailing a letter, citizen customers should experience good customer service from their public servants. From road workers to Congressman, public servants should be utilizing good customer service practices when dealing with their customers, i.e. citizen. Unfortunately, public servants, both elected and unelected government employees, too often forget they are public service. Health insurance reform under Republican leadership is as much about healthcare as it is about political ideology. This is why the GOP healthcare overhaul incorporates an attempt to shift regulatory control back to the States. Republicans argument that State control places decisions in the hands of State officials who better understand their local economies. In many respects, the logic is sound. Unfortunately, special interest groups often have a far greater presence in State capitals than than they do in Washington while State lobbyists receive far less scrutiny than Federal lobbyists. With such undue influence, State regulation does not necessarily reflect the interests of State residents.
To boot, a lack of regulatory consistency between State markets can impose costly complexities onto industry as well as limit the ability of insurers to offer far more robust insurance plans with far reaching coverage. National standards are needed for the health of the insurance industry and consumers. The Commerce Clause, which empowers Congress to regulate commerce between the many States, exists in the US Constitution, because technical barriers like regulatory disparities impede inter-state trade. For their part, many Republicans do want to make it easier for insurance companies to sell across State lines. If done properly, it is a policy shift that could transform the insurance industry, empower consumers, and ease regulatory burdens. The Better Care Reconciliation Act and the American Health Care Act are the Republican responses to the Affordable Care Act, commonly known as “Obamacare.” Because both proposals drop the individual and employer mandates, which exist to force people to acquire health insurance, while limiting the ability of insurers to deny coverage based on preconditions, criticism from the healthcare and health insurance industries is guaranteed. Because both gut Medicaid expansion and reduce government subsidies, criticism is guaranteed from both the healthcare industry and patient advocates as well as the poor. Criticism alone does not, however, determine the value of these legislative efforts. Their impact on the healthcare of individuals does.
Health insurance is supposed to make healthcare more accessible by making quality healthcare affordable to average income individuals and families. Unfortunately, the costs of healthcare and health insurance, along with deductibles and co-pays, have grown to the point an escalating number of businesses and individuals cannot even afford health insurance to pay for unaffordable healthcare. Ensuring Americans have affordable health insurance is not, however, the goal of healthcare reform. The goal is to ensure Americans have access to affordable and quality healthcare. In other words, successful healthcare reform does not necessarily hinge on preserving the health insurance industry. Republican healthcare reforms must, therefore, increase regular access to quality healthcare. The United States government under Republican leadership is seeking to pass health insurance reform, which will impact one-sixth of the US economy, dismantle government through crippling budgetary cuts, slash taxes for wealthy special interests, and expand American military intervention in the Middle East, along with a whole host of other partisan policy changes. There is nothing inherently improper about the Republican agenda as long as it is enacted with the input and majority consensus of the American People. The problem is that Republicans are not embracing transparency, they are not allowing for robust public debate, and they are not trying to address the concerns and interests of all Americans.
The role of modern government is to properly address and balance the interests of all the People(s) of a nation. This requires the People have effective representation of their views and interests in government. It also requires a culture of transparency where public officials understand even the deepest of government secrets will eventually be revealed to the public. When temporary obscurity is needed, good faith efforts, which actually reflect national interests, are essential to prove the trustworthiness of public officials. Government needs the People to trust government and the People need to be able to trust government. |
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April 2020
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