There are four themes I’ve learned about in Church that I have returned to from time to time in this column: feeding the hungry, welcoming the stranger, caring for our planet, and healing the sick. The budding election season is sure to highlight healing the sick, so it’s time to revisit the topic.
One goal of “Obamacare” when it was enacted in 2010 was expanding Medicaid to provide coverage to individuals and families with incomes up to 133% of the federal poverty level. The 2012 Supreme Court case that found Obamacare to be constitutional also found Medicaid expansion to be optional; individual states retain the option not to expand Medicaid. South Carolina is one of 21 states (mostly in the southeast) who have decided to opt out. South Carolinians, like all federal taxpayers, are paying the additional cost; it’s just that our state government has decided we should not receive the additional benefit.
You might well ask, the benefit to whom? The benefit would directly be felt by those who are poor, but not so poor as to be presently on Medicaid. These are working people whose daily lives are so restricted by their family income that they have to choose whether to pay for the food, shelter, and clothing they now purchase on the one hand, or for some medical insurance they have never been able to afford, on the other. “Disposable income” is not a concept for such families. It’s easy to say, as some have, that the government shouldn’t give “free” insurance to able-bodied adults. But these are adults who are barely scraping by, working hard at jobs that don’t provide them the medical insurance their families need. Their children are in public schools, because we as a society rightly consider education to be a “free” benefit not requiring an additional fee that some could not afford. We reason that public education benefits all of us: we are all better off when the children of poor families are educated. And yet we don’t see it the same way, when talking about the physical health and well-being of those families. We don’t note that we are better off at the store if the people shopping with us are healthy, not to mention the clerks who check our groceries, many of whom are in that health care gap.
The argument is also made that, unlike public education, the working poor should pay for at least part of their health insurance because we, as a society, cannot afford the additional cost. We boast of being the most prosperous nation in the world, ahead presumably of such countries as Germany, Austria, Finland, and the Scandinavian countries, not to mention nations such as the Czech Republic, Estonia, Latvia, and Lithuania, recently liberated from the Soviet bloc. And yet all of those countries provide “free” public health care to their poor and near poor citizens. Far from being bankrupt, all of them have seen their economies prosper over the past twenty years. How can they afford this, but we in the United States cannot?
But they, you might say, aren’t having at the same time to subsidize immigrants – documented and undocumented – who are constantly entering their countries and seeking the same prosperity that “natural born citizens” share. The answer to that is: of course they have faced an immigration crisis, in fact one more severe than ours, as anyone watching TV news recently can attest. And yet none of those countries would even consider withholding medical care from those immigrants, much less from their own poor citizens.
In societies such as ours that can afford to do so, we should and do support politicians who fight for “the right to a decent public education.” We should also support politicians who fight for “the right to decent public health care.” It is not only in our benefit – yours and mine – it is also the right thing to do.