This is tough medicine, but I still have to come down on the side of a total repeal of Obamacare. From my perspective, it’s really a simple equation. First, we have to decide IF we’re going to have Universal health-care or not. Apparently, this is where the tubes get tied, because Democrats are scared to repeal and start over and Republican’s can’t quite get up enough votes to do anything. It’s a deadly combination and the worst possible pathology – either way.
If we accept the premise of Universal health-care, then it has to be fair and equal. I don’t support the notion of block grants to states. This approach is roughly akin to the previously state scattered policy of marriage. I don’t have to like gay marriage, but I recognize the necessity, for a variety of business and policy decisions, of having a consistent and universal, national, application of “marriage.” Perhaps not incidentally, a national concealed carry for handguns almost fits this same conundrum – as long as we support the second amendment. In short, IF we have Universal health-care, it should be a “single-payer” type of “Medicare for all” system.
The first thing that can’t be included are religious exemptions for businesses – it violates separation of Church and State at face value. By definition business licensing is either commercial or non-profit. I have previously stated that Hobby Lobby has no right to deny coverage of birth control based on it’s religious rights. Hobby Lobby is the “it” in the last sentence, by the way, because it don’t have a religion. It is a commercial business with employees who may or may not agree with using birth control. No individual has to use a benefit simply because it is available. Individuals have a right to exercise their religious belief in context.
Which means, I don’t support the Trump administration’s rollback of the mandate for employers to provide contraceptive coverage. No employer should be allowed to deny standard “Universal Health-care” based on the employers religious doctrine – if they do, they are a Church and then must follow non-profit guidelines. However, in order to be fair and equal, I can’t agree to the inclusion of contraception, whether defined as “the pill” or defined as “abortion” as part of the standard to begin with. I.e. I’m still supporting a full repeal.
And please know this, I’m scaring myself just a little bit at how close I am to endorsing Medicare for all. But, it’s the only way to go because the crop and chop path we are now on lends itself to all sorts of ridiculous abuses and exploitations down the road, and the time to do it right, is right now – or not at all.
Medicare for all would ensure that people from less affluent states get the same coverage as those from more affluent states. This would also help to keep the economy in check by balancing wealth from state to state. It makes no sense at this point in time to shift this type of concept to state level. The world is smaller now than ever before, and like it or not, demographics are still shifting toward a more liberal mix. Going to block grants now will just forestall the inevitable, and make it a bigger, more costly tangle to shift it where it ought to have been in the first place.
Medicare for all doesn’t have to start like a Cadillac. Tough decisions will always have to be made about weather to cover a half-million dollar procedure for one person, or a five hundred dollar procedure for a thousand people. But, in order to be a fair and consistent system, it has to start off offering the same benefits to everyone. As a man, I don’t really see how it is fair for me to pay for a woman’s birth control pills when there’s absolutely no chance that I will be getting pregnant if I don’t use the pill. And, there’s no reason why supplemental insurance cannot be available to people who want additional coverage.
We can fight over the extent of coverage, and the attendant taxation later. For now, however, Universal Health-care should be Universal – or not at all.
© 2017 – Jim Casey
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