The following was sent to the Star-Ledger’s letters-to-the-editor in response to an article that appeared on today’s front page.
It’s worth having a discussion about the costs and benefits of providing a means of healthcare security for those who can’t find what they need through the traditional channels. If we believe that the foundations of our society require us to help those who find their lives in danger through no fault other than the draw of an unlucky card, then we ought to look at how we can provide what these people want, and if it can be provided at a cost that society can bear. This seems to be the promise of the March 16 article “Universal health plan: ‘This is the moment’ by Susan K. Livio. Unfortunately what it delivers is a dishonest diversion in a wholly different direction.
The article quotes State Sen. Vitale’s concern over residents’ “fear they will lose” their health insurance. The article quickly veers off course, though, suggesting “residents would be required to prove they have medical insurance”. This is not the discussion that was promised.
Offering to those whose circumstances make healthcare insurance important yet unachievable is one thing, but what is now on the table is forcing all residents -- even those lucky enough to be twenty years old and never sick a day in their lives nor responsibe to anyone but themselves -- to purchase insurance even if their health and responsibilities don’t require it. One can make a philosophical argument over the unfairness of denying healthcare to those less fortunate, but that would be a significantly different debate than one justifying that all people must, under penalty of the law, value their health in exactly the same way.
The sleight-of-hand is obliquely acknowledged when quoting Assemblyman Neil Cohen, who references those forced into the program against their will as a “captive audience”. But the charade is continued in the statement from the AARP that indicated “a vast majority of its members believe all state residents should have access to ‘affordable, quality healthcare’”. There is a world of difference between “having access” and being forced to purchase something regardless of your needs.
This is not just splitting hairs. Although the article uses the fact to make a different point, it contains the evidence that this is unwanted. It cites a plan to allow 50,000 children to get care through New Jersey FamilyCare, but only 14 have thus far been enrolled. Having 0.03% of their goal achieved after three months, it’s clear that the people are staying away in droves. No one should be surprised: people really are diverse, holding different values -- including for health -- and the government is trying to force everyone into the same mold.
The author fails to see this distinction, and similarly fails to employ critical thinking in other areas. “Three states that dared” are cited, conveying an entirely positive connotation, without taking any notice of their success. Indeed, at least the Massachusetts plan to cover the uninsured has been as unsuccessful as the recent FamilyCare initiative in New Jersey. It seems that there are some people who genuinely don’t believe that healthcare is at the top of their priorities, and even for those who do, a government-defined plan isn’t able to adequately meet the needs of everyone.
Neither is the author critical of the dubious funding prospects. That the vehicle for funding the program seems a longshot is besides the point. The real problem is that it’s quite impossible to finance an ongoing program in perpetuity by money derived from a one-time windfall. Of course, those advocating the plan aren’t concerned with funding: “this would be worked out at a later date” because money “wouldn’t be needed until the final stages”. The implication is that we should jump into this blindly, without considering whether the benefits are greater than the costs, or indeed if the costs can be born at all.
What our responsibilities are to our less-fortunate neighbors, and how we can make good on them, is an important question. By diverting the discussion into a domain of coercion and signed blank checks, we obscure the real question and prevent any constructive debate.