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Commentary

Doing nothing does harm

In a recent interview on CBS's

Face the Nation

, Sen. Joe Lieberman argued that a public health insurance option would be a terrible mistake. It would produce higher taxes and insurance premiums, and eventually push private insurers out of business.

When asked if he would prefer no health-care reform to a public option, the independent Connecticut senator said he would. The physical, emotional, and financial harm that will surely escalate without reform - and the disparities of health and life expectancy that correlate with a person's race and ZIP code - never came up.

Lieberman's anti-reform position raises a moral question: Should the richest country on Earth value the market so highly it allows people to suffer or die because they cannot afford medical care? It is one thing to oppose health-care reform and a public option on the basis that it constitutes an un-American subversion of private enterprise. However, given Medicare's success in covering millions of senior citizens who otherwise could not afford health insurance, it is difficult to make a blanket case against a government option without more specific economic or moral justifications.

So far, most opponents of a government option rely on abstract arguments that the market is more efficient than the government, and that it is offensive to require private companies to be less profitable because they must compete with the government. But such arguments are sustainable only if one is willing to ignore or tolerate the individual catastrophes and group disparities that the private market has produced.

For example, recent studies reveal that 54 percent of the unemployed cannot afford private insurance and are not covered by Medicaid. In Philadelphia, people of color constitute a disproportionate share of the uninsured. As of last year, adult Philadelphians without private or public health insurance were 32 percent Hispanic, 14 percent black, 5 percent Asian, and 22 percent white.

While lack of insurance is not the only factor contributing to health disparities, it certainly plays a role. The uninsured in Philadelphia are half as likely to undergo standard safety screenings such as mammograms and prostate exams.

The current reform debate has let the moral question of equity out of the bottle. Doing nothing reveals a willingness to accept the financial insecurity, emotional suffering, and physical pain that 44 million uninsured people - who are disproportionately African American and Latino - continue to suffer in a market system. The disproportionate harm of the current system should be made widely known, and the decision to reform or maintain the status quo should be made with our eyes wide open.

With unemployment having stricken every part of the nation, and with nearly half of young adults and people of color jobless in some communities, continued reliance on the market to open or close the door to health care reflects a political system that is morally bankrupt. Our government's answer to the question of whether we value human beings enough to assure them minimum access to health care will reveal a lot about where our country is headed.

In the meantime, academic, health-care, business, legal, and social-service experts should work to highlight and address the significant disparities in our own back yard. Such efforts are desperately needed and simply the right thing to do.

 


Frank McClellan is a law professor and codirector of Temple Law School's Center for Health Law, Policy and Practice. The center is sponsoring a conference on health disparities tomorrow at the law school. For more information, see www.temple.edu/lawschool/

healthdisp.

 

Comments   
Posted 03:36 AM, 11/12/2009
bobbyquiroz
You can get instant full medical coverage at the lowest price from http://bit.ly/39pFJx
Posted 06:46 AM, 11/12/2009
p.e.poole
What about the morality of leaving a country solvent for future generations? What about the morality of paying for what you get. There are disparities in what people eat. Should the government take over the food industry to make it right. You are a Marxist in professor bowtie. A public option is as necessary to fix health care as a govt run airline is to make air travel more equitable.
Posted 07:10 AM, 11/12/2009
EchoesoftheEnlightenment
p.e.poole, your analogy to airlines is seriously wrong. People don't need air travel to live. Take away air travel, and people don't suffer. Take away health care, and they suffer and die. You market ideologists put money over human life. It's that simple. America, wake up! Americans are getting fleeced! The average American pays more than twice as much for health care as citizens of other developed nations, and our outcomes are worse! Why are we paying more for less? Why are all the people who say they are concerned about health care reform's effect on the economy so determined to make us keep paying more for less?
Posted 08:08 AM, 11/12/2009
p.e.poole
I'm talking about the public option. It is not necessary to reform health care. At a minimum, subsidies for those who can afford to contribute something health care insurance, Medicaid or regional health centers who can't. Philadelphia offers free health care to its residents through 10 regional health centers. To suggest people are dying is hyperbole. People die in socialized countries too, often times because health care is denied. The author suggests nothing is not an option. I wouldn't argue with his point. Where I totally disagee is this Marxist concept that it is govts role to equalize society, as this is ever possible, and that we need a public option to do so. It is pure Marxist poppycock.
Posted 08:11 AM, 11/12/2009
p.e.poole
"Why are all the people who say they are concerned about health care reform's effect on the economy so determined to make us keep paying more for less?" This reflects a complete lack of economic understanding. To pay less doesn't mean it costs less. It just means you won't pay for the true costs, and only two things can result: a reduction in supply which will raise costs and waits even higher, and/or a reduction in quality. My definition of reform is getting more for less. Obamacare will do exactly the opposite in every respect than what it claims.
Posted 08:23 AM, 11/12/2009
p.e.poole
Reform is getting more for less. If properly analyzed Obamacare will do exactly the opposite: give us less health care for more. Premiums will go up, taxes and fines will go up, waiting for care will increase, and quality and innovation will decline. How's that for hope and change??
Posted 08:58 AM, 11/12/2009
longshanks
"health care reform." That's a code word for do nothing. There will never be any reform because those private insurers are deep in the pockets of politicians, including many many Republicans, so they will refuse to be pushed around. Money talks. There will never be any reform.
Posted 09:03 AM, 11/12/2009
longshanks
p.e.poole, you don't know what you're talking about. You obviously just like to hear yourself talk. Try watching the following WHYY/PBS program, Sick Around The World from 2008, and maybe you'll learn something about national health care or you'll likely refuse to believe because you believe in capitalism at all and any costs. http://video.whyy.org/video/1050712790/chapter/1/feature/87/tag/health%20care
Posted 09:12 AM, 11/12/2009
Carl07
A WHYY/PBS Program? I'm sure THAT was an unbiased program! Believe that and you should believe a fat guy in a red suit is coming down your chimney on 12/24.
Posted 09:34 AM, 11/12/2009
longshanks
Carol07, it presents the facts. Sorry you've confused right-wing propaganda with balanced news but you're a sheep and sheep follow so I guess we can't blame you for being a niwit.
Posted 10:23 AM, 11/12/2009
DavidGtown
It is sorta a shame that the portion of the media that right-wingers claim is "fair" is essentially the worst of it--Fox & talk radio. And the part they claim is "liberal" is pretty much the best of it: the NY Times, newspapers & public radio. They pretty much just ignore the actual liberal media (Mother Jones, The Progressive, The Nation etc.), which is, I suppose, so far out of their radar that they don't even know it exists. In any case, it's no surprise they're so short of facts.
Posted 10:26 AM, 11/12/2009
EchoesoftheEnlightenment
p.e.poole, when you stop running around like Chicken Little, crooning about the demise of our economy, you might actually learn that we are paying more in the U.S. and getting less. According to an OECD study of the health care spending per person in industrialized nations, in 2007, the U.S. spent $7290 (per person), next was France at $3601, then Germany at $3588, then the U.K. at $2992, then Italy at $2686, Spain at $2671, and Japan at $2581 (2006 data for Japan). Yet all of these countries have longer life expectancies, lower infant mortality rates, and numerous other better health metrics. We pay more for less than what those countries get! Of course, you bring out the canard about waiting for care. I've got news for you, it happens here, too! A few years ago, I tore cartilage in my knee. I had to wait 3 months to see a knee specialist and then wait another 2 months to get surgery. And I had health coverage. You need to get your head out of the sand and see what really happens to your fellow citizens. I predict that you won't do that--instead you'll keep throwing out accusations of Marxism.
Posted 10:38 AM, 11/12/2009
Carl07
Fox news is absolutely right wing. Just like the NY Times, PBS, etc are left wing. Anyone who doesn't see that either doesn't want to see it or is just ignorant.
Posted 10:39 AM, 11/12/2009
xi_lives
I couldn't disagree more....if only our politicians would do less.
Posted 10:56 AM, 11/12/2009
EchoesoftheEnlightenment
So you don't believe that people die from lack of health insurance, p.e.poole? According to a recent study from the Harvard Medical School, about 45,000 Americans die each year from lack of health insurance . http://ajph.aphapublications.org/cgi/content/abstract/99/12/2289?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=wilper%2C+a&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
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