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Healthcare: The Fairest System is the Most Unequal

Those in favor of systemic healthcare reforms will tell you that our current healthcare system is unfair. A June 6, 2009, NY Times editorial noted, “to abandon the goal of universal coverage…. would be unfair to the 46 million uninsured Americans….” It’s time to pause and define our terms as we consider what kind of national healthcare system we want in this country, and the forthcoming August Congressional recess gives Congress and Americans alike that very opportunity. life libertyAt issue is the difference between EQUALITY and FAIRNESS. Our common American interest in equality stems from one of the best known phrases in our founding documents: “We hold these truths to be self-evident, that all men are created equal….” Equality, as noted here, does not guarantee equality of experience, but rather equality of opportunity. All men are CREATED equal, the preamble to the Declaration of Independence says. This is a declaration concerning the immutable value of every human citizen and a promise of opportunity unconstrained by prejudice, not a promise concerning quality of life. The attendant rights associated with this valuation of human life are that all men “are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness” (not prosperity, housing and healthcare). Our unalienable rights deal with the process of the American experience. There is no promise of success or guarantee of reward. What we are granted, as Americans, is EQUALITY OF OPPORTUNITY, not equality of experience. Governments established on the precepts of equality of experience are defined as communist—the sharing of collective resources for the utilization of the group. Is equality of experience what we want in America? Is it UNfair that some Americans have health insurance and some do not? It is UNFORTUNATE, but it is not UNFAIR. What’s UNFAIR is the current financing mechanisms under consideration in Congress for healthcare. robin_hood_classicIs it fair that someone would study hard and get good grades in high school so that he can go to college, where he studies hard and gets good grades so that he can get a good job with health benefits, and then to have his salary taxed so that those who have squandered those same opportunities might have EQUAL benefits? These Robin Hood economics are fundamentally UNFAIR. Fairness would ensure equal reward for equal investment. What Congress is considering is equal reward for disparate investment. The United States has many problems and is not without its faults. Yet many, many citizens find ways to take advantage of the opportunities they are afforded. A free, appropriate public education is afforded to all American children. school busThousands of youths every year, in the very worst public schools, are able to work hard and use the education they are provided to get into college where new opportunities await. Meanwhile, many of their peers choose to be victims, forfeiting the opportunities they have because they perceive their opportunities aren’t equal to opportunities afforded to other segments of American society. Notwithstanding the veracity of the latter, the real shame is that they cannot see what they’re forfeiting. Yet, as adults, these same individuals cry out because they do not have benefits that others have. They do not have those benefits because they have not earned those benefits. No one wants life to be fair; they want it to be unfair in their favor. Any future healthcare system should perpetuate the historical American understanding of EQUALITY and FAIRNESS—what is FAIR is that all Americans have equal opportunity. Ensuring equal access to a system that provides incentives for hard work and disincentives for sloth is in keeping with American values. There should be varying degrees of healthcare coverage to reflect the vary degrees of investment individuals make in obtaining those benefits. There should be extra reward for extra work. As it turns out, the fairest system is also the least equal. I’m comfortable with that.
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It's the Constitution, Stupid

There are little nuisances in life; and there are BIG nuisances. The bigger nuisances usually make my heart flutter and my stomach churn: I can’t get my mind off of them and I am constantly angling in my head for ways to avoid them.

sotomayerThere was much about the recent nomination hearings for Supreme Court nominee Sonia Sotomayor that left me feeling uneasy. (The Senate Judiciary Committee has scheduled a vote for Tuesday and her confirmation is all but assured.) In hindsight, most of that unease is reactionary and emotional.

I, like most people I’m sure, understand the importance of the Supreme Court Justices. With their lifetime appointments, they have the ability to greatly affect America’s strength and longevity. I am in no way surprised by President Obama’s nomination. For better or for worse, Sotomayor’s confirmation will have little anticipated effect on the Court’s operation and leanings. She is expected to take the ideological place of the same judge whose position on the court she is assuming—David Souter. Souter, though nominated by George H.W. Bush and assumed to be a conservative at the time, was a part of the Court’s left-leaning axis, along with Justices Stevens, Ginsburg and Breyer.

tequilaJustice Souter’s departure left me pondering whimsically what could have been if only a different president was making the nomination. Evaluating Sotomayor against the hypothetical is what made my stomach feel as if I’d had ten tequila shots last night. But watching the hearings left me with no such nausea: in fact, just the opposite. Because she delivered much of what I expected, I had little frustration, and I was free to evaluate the proceedings on a different level.

What struck me most, and left me feeling both confident and nauseous about the state of the Republic, was the emphasis on our Constitution. This should be no surprise—this is, in fact, the job of a Supreme Court justice.

Many inquisitors cloaked their partisan questions in a Constitutional light; that they felt compelled to do so reinforces the importance of the Constitution in the conduct of our government. No matter what the intent of the question, or the politics of its asker, the very fact that Republicans and Democrats alike paid homage to our Constitution in this manner is evidence of the shared values of Americans from both parties. It reminds me that our shared love for this document and belief in its perpetuation and application serve to unite us as Americans more than divide us as partisans.

AP GOP Minorities DebateBut unease churned my stomach when I noted how infrequently Constitutional dialogue is included when other legislation is created. Congressman Ron Paul (R-TX) brought a Constitutional emphasis to last year’s Presidential election but his message was lost amidst his screeching, nearly hysterical delivery. Heaven forbid Congressman Paul is ever in charge of anything, but I wish he had a place on the President’s team. Maybe he could hold an honorary position in the President’s entourage. He could just sit quietly in the back of the room until his strident adherence to the Constitution was needed. Whether it should be heeded or not would remain the providence of key decision makers, but it would be nice to know that the Constitution itself was explicitly afforded a hearing in the policy making process.

npr2The daily news, with its Red State/Blue State graphics, and the juxtapositions of FoxNews and MSNBC or NPR and the EIB Network can leave one with the impression that this country is one poorly timed shooting away from another civil war. But the confirmation hearings brought out the very best of the American political system—differing viewpoints on how to achieve a common objective: support and defend the Constitution of the United States.

constitutionThe Sotomayor hearings showed me once again that the American Gospel is that those whom the Constitution serves value it above all else. Too many Sotomayor-like nominees will make me wretch, indeed. But the Court remains in balance for a variety of reasons and I can’t help but think that its current teeter is in keeping with American opinion. So, for today, I am not concerned about Justice Sotomayor. Neither am I thrilled. But, and this is more important, I am optimistic about the American form of government and its viability for the 21st century because its real strength lies in those it serves. Now it’s our job to demand that Congress heed the Constitution as much during the health care debate as they did during the Sotomayor hearings.

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