Obama Can Boast 7.1 Million Reasons to Call Health Reform Gamble a Success

Put simply, health is the cornerstone of freedom, which is why some people describe health care as a human right.

With the most recent deadline to obtain health insurance under the Affordable Care Act (or ACA, more widely known as Obamacare) passed, President Obama has 7.1 million reasons to call his big health reform gamble a success. As health care professionals — an emergency physician and public health professor — we can attest to the power of the president’s victory. Indeed, everyone (young or old, healthy or not) should have access to health care.

But even as we celebrate this historic achievement, we should keep in mind that 15.6 percent of us (nearly 50 million Americans) remain without coverage. In other words, the recent ACA deadline brought us closer than ever to universal coverage — but we’re still not close enough.

As millions of Americans stand to benefit from the ACA this year, the law still faces legal challenges and remains the subject of controversy for millions more. Critics of providing universal health care argue that it goes against Americans’ aversion to big government. These claims, however, consider a limited subset of history that considers events like the Boston Tea Party and individual rights outside of their full contexts. In doing so, they ignore that the drive to protect citizens from the perils of disease dates back to Theodore Roosevelt’s 1912 Bull Moose Platform, and that efforts to vaccinate Americans against communicable diseases continued throughout the twentieth century.

What Roosevelt and so many of his predecessors (Franklin D. Roosevelt, Harry Truman and Richard Nixon to name a few) realized back then is that a healthy populace is essential if a nation is to develop and thrive. This realization eventually led to the enactment of the American Social Security, Disability and Medicare programs. In more recent history, Ronald Reagan established the Ryan White Care Act, which still provides a safety net to individuals living with HIV/AIDS and have little access to life-saving drugs and care.

Similarly, George W. Bush established PEPFAR (The President’s Emergency Plan for AIDS Relief), a program that has saved millions of lives worldwide. And while PEPFAR differs only in that it is not a domestic program, all of these programs clearly demonstrate what we can accomplish in healthcare — both at home and abroad.

There are also those who protest that providing health care for all is an impingement on freedom and individual choice. But accepting this argument requires a very narrow definition of freedom, one that assumes that all choices are available to all people at all times.

This is simply not true. The choices we make are limited by the options available to us (financial or otherwise), and it is an unfortunate fact of life that illness makes us vulnerable and dependent. This is especially true in the case for a catastrophic, debilitating, or chronic illness, where the misery and suffering is felt not only by the one who is sick but also by his or her family. In other words, lack of health care access limits our choices and curtails our freedoms.

Put simply, health is the cornerstone of freedom, which is why some people describe healthcare as a human right. By extension, any measure to extend access to health care is a necessary step toward the expansion of freedom — even if that measure comes in the form of policy initiatives or legislation.

Others who may agree that we should provide health care for all may shake their heads at the unfortunate irony that we simply cannot do this. They point to the fact that the United States already spends more per capita on health care than any other developed nation and that increasing access to health care will inevitably increase costs. A little cited fact in all of this, however, is that administrative bureaucracy makes up nearly a third of health care costs.

Thus, the key to cost cutting is not to deny care to the most vulnerable among us, but to streamline access to providers. In fact, a recent study that compared the United States and Canada indicated that universal access to health care not only improves disparities in access, but also promises to reduce costs.

It is difficult (if not impossible) to make an argument for universal health care without a discussion of the Affordable Care Act (ACA), whose implementation has run into well-publicized bureaucratic and public relations difficulties. These difficulties have fuelled the bitter divisions surrounding this legislation and threatened to further derail access to care for millions of Americans.

Certainly, the ACA is not a complete or perfect solution to the current healthcare crisis. But this does not negate the fact that the old system is by far worse than the current government reforms. In an ideal world free of partisan bickering and special interest intervention, we would all have access to basic health care. In that world, the health care would perhaps resemble the Medicare coverage we are all (rightfully) protective of, but it would not divide us based on age, gender, or class lines. Sadly, we do not live in this world and until we do, the ACA is a much-needed step in the right direction.

We expect our government to ensure the safety of the food we eat and the drugs we take, which are regulated through the Food and Drug Administration. We expect it to ensure the quality of, the water we drink, which is regulated by the Environmental Protection Agency, and the roads we drive on, which are overseen by the Department of Transportation. It is only sensible and logical to expect our government to make sure our physical and mental health are valued and protected.

Like safe food, clean water and well-maintained roads, quality health care should be accessible to all. Better health is a prerequisite for a healthy, productive, developed society. The ACA gets us moving in the right direction by outlawing denial of care based on illness and “pre-existing conditions” and making coverage more accessible. But for some, health care remains prohibitively expensive and inaccessible to those living in states that have rejected the Medicaid expansion.

This year, instead of bickering about exaggerated ideological differences, we should recognize that these changes are to our common benefit. Instead of focusing on narrow goals that we’ll soon abandon, let’s learn from history and recognize that our ultimate goal is to streamline and universalize access to medical care for everyone regardless of age, gender, or state of residence. To do this, we must take advantage of the election cycle.

As the parties prepare their platforms and promote their candidates, we should keep health care an active election issue by making its importance clear to candidates on the campaign trail and on Election Day. We should also take advantage of our social networks (online and in person) and our place in membership organizations by voicing our support for the expansion of health care for all.

Bisan Salhi is a Public Voices Fellow at Katie Orenstein's Op Ed Project. Salhi is also an emergency physician and Ph.D. student in anthropology at Emory University.

Frank Wong is a professor of Public Health at Emory University. 

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