Quality of life is directly proportional to a person’s health. Obviously, health is not the only determinant of quality of life. Other factors that contribute to a person’s quality of life include loving, meaningful relationships, the presence of beauty, freedom, etc. Yet without health, the ability to live fully and to experience the greatest possible quality of life diminishes. In the extreme, the person whose condition confines him/her to bed has a greatly diminished quality of life.
The pivotal role of health in determining quality of life makes access to affordable healthcare vitally important. Thanks to the courageous vote of Senator Olympia Snowe, Republican from Maine, healthcare reform now has an improved prospect for passage this year. Five different Congressional Committees have sent healthcare reform to their respective House. Few people, if anyone, view any of these bills as ideal; none of the proposed legislation is a panacea. However, all of them represent a step forward from a nation in which approximately 1 in 6 people lacks healthcare coverage.
People sought Jesus to heal them or a loved one. However one understands that healing (psychological, psychosomatic, spiritual, physical, etc.), the gospel witness is undeniably clear: people experienced God's healing love in Jesus. God similarly calls the Church – the incarnate body of Christ on earth – to heal people. This calling does not mean to substitute prayer for modern medicine. This calling compels us to support legislation that moves toward ensuring everyone, absolutely everyone, has guaranteed healthcare coverage.
Our Baptismal vows emphasize that God made every human – citizen or not, old or young, straight or GLBT – in God's image. Every human is therefore worthy of dignity and respect. God intends each person to have life and to have life abundantly, a desire possible only when a person enjoys the best possible health, allowing each to maximize her/his quality of life.
Individual responsibility for one’s own self is important. Recent research demonstrates that people who exercise moderately have better health, e.g., higher resistance to cold and flu viruses. (Gretchen Reynolds, “Phys Ed: Does Exercise Boost Immunity?,” New York Times, October 14, 2009) Government cannot compel citizens to exercise regularly anymore than government could compel citizens not to drink.
However, utilizing market mechanisms to encourage healthy behaviors can effectively encourage people to adopt healthier lifestyles. North Carolina has rightly modified the healthcare coverage for state employees so that those who smoke or are obese will pay more for that coverage. As one might expect, howls of protest are now heard from those opposed to this approach, e.g., lobbies for the obese, smokers, etc. North Carolina should ignore those protests and stay the course. Egregiously unhealthy lifestyles diminish that person’s quality of life and increase the cost of healthcare for that person. To the extent that the unhealthy lifestyle results from medical problems, the healthcare system should treat the problem and proportionally lower the additional healthcare premiums that person pays. Market mechanisms have a proven record of successfully encouraging lifestyle changes in people.
The moral problem with relying upon market mechanisms to encourage people to purchase healthcare coverage has two dimensions. First, we as a society should never deny anyone necessary and appropriate healthcare. Currently, the law requires hospitals to treat people without healthcare coverage. Those people obtain care in hospital emergency rooms, the most expensive source of medical attention. Taxpayers and those of us with healthcare coverage pay for most of that care because the significant majority of people without healthcare coverage do not have the financial resources to pay for their own care. In other words, taxpayers and those with healthcare coverage pay the bill, a much more expensive bill than if everybody had some form of healthcare coverage.
Second, most people without healthcare coverage avoid seeking medical care as long as possible. These people not only receive little or no preventive care (an important way to minimize costs) but also allow illness/injury to require more extensive, more costly treatment than if the person had sought help sooner. Both of these factors combine to drive the already high costs of society providing healthcare for those without healthcare coverage higher than for other people.
In sum, allowing individuals to decide whether to have healthcare coverage carries with it a significant, adverse impact on everyone else. Mandating healthcare coverage for everybody improves the quality of life for all and reduces the total healthcare costs. With mandatory healthcare coverage, everybody wins. Without mandatory healthcare coverage, everybody but the very rich and the fortuitously healthy lose.
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