1)Most Americans believe that health care should be affordable and readily accessible; however, they are deeply divided about what this means. Some believe health care is a basic right and the federal government has an obligation to help those who can’t afford it. Others believe that greater free-market competition will ensure health care is made affordable and believe the federal government has no obligation to help those who can’t afford it.
The Affordable Care Act, narrowly passed into law in 2010, expanded the government’s obligation to help those who cannot afford health care by expanding Medicaid (poor) and subsidizing the purchase health insurance (middle class). Despite reducing the uninsured rate to historic lows, the ACA remains controversial. After the 2016 election, Republicans controlled the House, Senate and Presidency but were unable to “Repeal and Replace” the ACA with an alternative.
Unlike most other developed countries, health care is not a constitutionally recognized right in the US. Instead, the federal government has enacted a patchwork of laws that make health care affordable for some Americans but not others; Medicaid provides health insurance to some with low-incomes and Medicare provides health insurance to the elderly. If someone is injured, ill or pregnant, hospitals must provide stabilizing care without regard to cost.
In “Politics, Health Policy, and the American Character,” Lee et al. articulate four important values that define the American approach to health care: individualism, distrust of authority, ambivalence towards social equality, and distributive justice. These core values influence public attitudes towards health care as described by Blendon and Benson in, “Public Opinion about the Future of the Affordable Care Act.”
How you view the government’s obligation to provide health care will be strongly influenced by your beliefs and attitudes regarding health care as a basic right and your willingness to subsidize the expenditures of others to ensure it. As you examine your beliefs, you will likely find them to be consistent with those of market justice or social justice.
a. State whether you believe health care is a basic human right and what obligation, if any, the government has to help Americans’ obtain affordable health care.
i. If you believe health care is a right, what role should the government play to ensure that health care is affordable?
ii. If you believe health care is not a right, why it is appropriate for the government to provide health care to some Americans but not others.
