How to Pay for Health Care, Not Whether we Can or Should

The news today that the unemployment rate dropped is unabashedly good. Of course, almost a quarter of a million jobs were lost last month, a piece of data that contains an enormous amount of human suffering. And, the White House says it still expects the unemployment rate to rise to 10 percent by year’s end.

It will be curious to see how the administration’s opponents will respond to the news. Just yesterday, they were arguing that the stimulus bill was not working, although it was always clear that it would take more than a few months for the effects of the stimulus to be felt; You don’t just plunk billions of dollars into the economy, you have to identify projects and get them the funding.

There are competing aspects of the American national character at work in assessing the President’s performance on the economy. On the one hand, Americans are leery of too much government spending. On the other, in times of economic crisis, they want the government to do something. At its most basic moral level, the stimulus said to the American people that we are not powerless before the impersonal laws of the market. You may agree with the size or manner of the stimulus, but it is difficult to argue with the impulse to do something. Additionally, although the President will get no credit for this, the critics fail to note what might have happened if the stimulus bill failed. Americans, including those who make decisions about hiring, might have indeed felt powerless and the recession could have been deeper than it is already.

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As the country spends the month of August debating health care reform and its costs, it is good to remember that had we not spent all that money on the war in Iraq, that money could be devoted to health care reform. It is also good to remember that the Obama administration’s deficit projections look worse in part because they have stopped the ridiculous, even dishonest, practice of the Bush administration which kept spending on the Iraq War off the books.

America can afford universal health insurance and it is beyond doubt that we cannot afford to keep the status quo, financially or morally. The debate should be about how to pay for it, not if we can afford it. Hopefully, if the economy rebounds sooner than anticipated, the out-year deficit predictions will look better too. But, whatever the budgetary constraints, the moral obligation is the same: Too many Americans, even those who have health insurance, are denied coverage because rapacious insurance companies are more concerned about their profits than they are about the health of the American people.

All those who lack health insurance, all those who have a prior condition, all those who worry about changing jobs and its effects on their insurance, all those who can barely afford to pay for the insurance they have, all the small businesses that want to provide their employees with health insurance but can’t afford to, all of these people have a stake in achieving health care reform. Shame upon the nation that turns away from such moral obligations.

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