For all the in-depth analysis of what the just-passed health care reform bill does for ordinary Americans, and the intensely personal nature of the health care debate up to now, the most significant achievement tonight was actually an abstract one. For the first time in American history the Federal government is legally and profoundly committed to universal health insurance.
All future tweaks and fixes will be predicated on the fulfillment of this principle. The bill obviously doesn’t cover 100% of the population. And there are segments of the population whom many believe should never receive coverage – or even be here in the first place – illegal immigrants, for example. But for law-abiding Americans – legal immigrants and US citizens – the principle of universality is a real one. The United States has now joined every other modern industrial democracy in offering health insurance to everybody.
Could this principle ever be undone? Here in Tennessee our current Governor removed many recipients from our flawed TennCare Medicaid program. But he did so in the context of a state program expanded without due funding from the Federal government. Some Representatives, including Phil Roe of the First District in Northeast Tennessee (and a former physician) used the TennCare debacle as a reason to avoid promises of universality.
While the fraud and inefficiency in TennCare was real, the problem is just not replicable to the Federal solution at hand. The Federal government (unlike our state with its lack of an income tax) can – and will – always find money to fulfill its principle of universal access. I do not believe that the Federal government – unlike Tennessee – will ever renege on its commitment to universality.
Yes, that will mean tax increases at times. And it will mean some sort of rationing.
But I believe that it’s worth it. I have health insurance through my employer. And my premiums go up year after year – far faster than inflation. I don’t know if this particular bill will help me personally.
But I do know that the principle of universality that the Congress has just formally adopted is the morally right one for this nation.
I believe, firmly, that health care is a right and not a privilege.
I believe, firmly, that all Americans should have access to a primary care physician so that the first trip to a doctor won’t be the emergency room.
I believe, firmly, that the United States has just embraced a principle every bit as sacred to this nation’s future as those laid out in the New Deal or even in Reconstruction.
I believe, firmly, that the principle of universality embraced by our national government has made America a more free and more just place.