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American Values And Health Reform



September 25th, 2009

During the current health reform debate, both Democrats and Republicans have often made their case in terms of values such as liberty, justice, and equality. One example has been the Republican opposition to the “individual mandate” – requiring everyone to purchase health insurance if “affordable” coverage is available – which Senator John Kyl of Arizona called “a stunning assault on liberty.”

Is the individual mandate consistent with American values? In an essay in the Hastings Center Publication “Connecting American Values With Health Reform,” philosopher Paul Menzel answers yes. Without an individual mandate, it would be unjust to require hospitals to provide acute care to all comers, he writes. It would also be unjust to bar insurers from excluding people with pre-existing conditions, as most proposals to achieve universal coverage would do, argues Menzel, a professor at Pacific Lutheran University.

Menzel acknowledges that, while “mandating insurance may be just and fair,” it “certainly appears to limit liberty.” However, he argues that this apparent conflict between justice and liberty can be addressed by considering liberty “in its fullest context, bound up with responsibility – where both are connected to fairness and justice.”

Each of the essays in “Connecting American Values” begins with a particular value and its connection to the health reform debate, but an interconnected view of values is one of the themes that runs through the publication. For example, in his introductory essay, Hastings Center president Thomas Murray argues that:

simplistic understandings of values are deceptive and harmful to private insight and public discourse. Liberty, properly understood, is not the opposite of equality; justice, not the opposite of liberty; and responsibility, both personal and social, is crucial to the full realization of liberty and justice. Efficiency, an instrumental value rather than an end in itself, is intimately related to quality, solidarity, stewardship, and justice. Core American values, rather than existing in ineluctable tension with one another, form a sturdy, mutually reinforcing foundation for health reform.

With the support of Health Affairs as a media sponsor, Hastings is seeking to broaden the discussion regarding the intersection of American values and health reform. Next week, the Center is launching a Web site that will feature new blog posts on values and health reform. Contributors are invited to respond to one or more essays in “Connecting American Values,” to each other, or to strike out on their own. Some contributions will be co-posted on the Health Affairs Blog. Stop by the site and join in the discussion.

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3 Responses to “American Values And Health Reform”

  1. Dr. M.Z.Younis Says:

    This is a nice post for discussion. However, the facts support both sides. For example, the argument of the philosopher Paul Menzel (with all due respect) is misleading. Hospitals do not provide free health care. Usually, hospitals recover some of the costs of treating the needy in various ways. Hospitals get “DSH” payments and write off uncollected bills that reduce their taxes. These are just a few of the ways hospitals recover their expenses.
    Mandating health insurance will provide insurance firms with a windfall of revenues, and the premiums will keep going up as we have seen in the case of auto insurance. Americans have the right to reject treatment and should not be forced to buy health care insurance.

    The government could solve the health care crisis by imposing a 2% tax to cover a universal health system. In the past, the government has shown moral bankruptcy by raising revenues from casino operations rather than by increasing taxes. Now the government is showing another form of moral bankruptcy by mandating health insurance and limiting people’s freedom instead of imposing health insurance taxes.
    I ENTIRELY DISAGREE–a universal health plan (not necessarily insurance based) is urgently needed, but that would not obviate the availability, use of or need for health insurance and the companies that provide it!

  2. Dr. M.Z.Younis Says:

    This is a very nice post for discussion, however, the facts support both side.
    For Example, the argument of the philosopher Paul Menzel (with all due respect) is misleading.
    Hospitals do not provide free health care. Usually hospitals recover some of the cost of treating the needy in various ways. Hospitals get “DSH” payment, write off uncollected bill and which reduce their tax payment. This just a few ways to recover their expenses.
    mandating health insurance will provide insurance firms with windfall of revenue and the premium will keep going up as we see in the case of Auto-Insurance.
    Americans has the right to reject treatment and it is their own liberty to be forced to buy health care insurance.
    The government could impose 2% tax to cover universal health system. In the past the government show that they are morally bankrupt by raising revenue by opening Casinos instead on increasing taxes. Now the government is showing their moral bankruptcy by mandating the health insurance and limiting the people freedom instead of imposing health insurance taxes.

  3. SteveBeller Says:

    Excellent post!

    Earlier this week I wrote an article in my blog that is relevant to this issue. It offers four criteria and eight objectives for creating a sustainable healthcare system.

    The four criteria are:
    1. Self-Discipline
    2. Personal Responsibility
    3. Public Accountability (Transparency)
    4. Empathy and Compassion for the least advantaged.

    For more, please visit http://curinghealthcare.blogspot.com/2009/09/criteria-for-sustainable-health-system.html

    And last month I wrote about a principled and pragmatic approach to healthcare reform that emphasized empathy and compassion, as well as the need to answer these two questions:

    answer these two unaddressed questions:

    1. What is the most cost-effective ways to prevent, diagnose, treat and manage health problems for each person?

    2. How can healthcare providers and consumers be enabled and encouraged to make decisions and take actions that implement those cost-effective ways of avoiding, understanding, and treating/managing health problems?

    See this link for more http://curinghealthcare.blogspot.com/2009/08/principled-and-pragmatic-approach-to.html

    Keep up the good work!

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