It has come to my attention that an acceptable way to discuss a controversial topic without alienating a significant chunk of your target audience is to introduce said topic under the auspices of a “thought exercise.” Rather than committing to an idea, we simply use our god-given critical thinking abilities to consider it.
And so I invite you to join with me in a thought exercise:
Let’s say that I am careful driver. I never deviate from the speed limit. I hold my hands at 10-and-2. I keep my cellphone on silent in the glove compartment. Furthermore, I drive a car with all of the latest safety features. Cameras and warning lights everywhere. I have perfect vision, and an undivided mind. But one night, I am driving on a two-lane highway, and a deer strays out onto the road. I swerve to avoid it, but in doing so, I cross the double-yellow line, where an oncoming car is then forced to swerve to its right to avoid me, sending said car nosediving into a drainage ditch. I pull off to the side of the road, yell an obscenity at the deer, and run across to check on the other car. The driver is an older woman, probably in her late 60′s. She is unhurt. I help her out of the car. I take out my cell phone to call for a tow truck. I hand the cell phone to her so that she can provide AAA with some information. I don’t even think about the fact that I am just getting over a bout with the flu that kept me home from work two days earlier in the week. But a few days after we go our separate ways, the elderly woman ends up in the hospital, her immune system overwhelmed by the virus.
Unfortunately, this woman does not have health insurance, and she is hit with a five-figure bill for her stay.
Question: Is this woman alone to blame for her sudden financial predicament given her decision not to carry health insurance? Or do I merit some of the blame for infecting her with the virus that landed her in the hospital?
The question is an important one, because from what I can gather from folks on both sides of the health care debate, every individual in our country is alleged to be the sole guardian of his or her own health, and when we purchase health insurance, we do so to protect our own individual health. One side thinks we should have the freedom to choose against insuring our own individual health. The other side thinks we should not. Either way, the issue is framed with regard to our own personal health.
But what if we framed the issue in a slightly different manner? No doubt, an individual bears the bulk of the responsibility for his or her well-being. The individual chooses what foods he or she eats, what exercise he or she engages in, what substances he or she ingests. Yet does an individual choose what viruses he or she is exposed to, or what hazards he or she encounters when walking about town? Is it really logical for residents of a dense, industrialized nation to contend that an individual’s health, and his or her ability to treat that health, is a consequence solely of that individual’s circumstance? Or can we all agree that the circumstances of each individual will always be, to a certain degree, linked to the circumstances of the rest of the individuals in his or her society?
Any of us who drive a car already acknowledge this with regard to our fellow motorists. I am required to carry auto insurance not for my own well-being, but for the well-being of those who I have the potential to injure when operating my vehicle. Why, then, is it such a leap to think that each of us who operates a body should bear some responsibility for the harm that said body can inflict on others? We are all carriers.
The auto insurance mandate is not the source of constitutional challenges because purchasing auto insurance is still a choice: if you do not wish to do so, you can choose not to drive. To differentiate that mandate from one that requires every person to purchase health insurance, you can argue that we, as Americans, do not choose between operating our bodies and not operating them. Each of us has the right to life, liberty, and the pursuit of happiness. Saying that we must purchase health insurance to live in America is saying that we must purchase health insurance. But it is at this point that the logic collapses, because the debate about health care is a debate about how much life, and what quality of it, each of us has the right to. How long does my right entitle me to live? If life begins at conception, then am I self-determinant from that point on? And if not, when does my self-determination begin? The fundamental question — and the fundamental disagreement — is what constitutes the life to which we have the right as Americans? It is the fundamental question that underlies every piece of legislation that this country has ever enacted. And I would suggest that, upon careful enough examination, somewhere within each of those pieces of legislation you will find at least a tacit acknowledgment that the operation of our lives is in some way dependent on the operations of the lives of our fellow members of society, in the same way that the operation of our vehicles is in some way dependent on the operations of the vehicles of the rest of our fellow motorists. And, in that light, the requirement that each of us — or, in our stead, our government — insure the bodies of ourselves and each other against the circumstances of ourselves and each other would not be an infringement on the basic rights conferred upon us by our constitution but an acknowledgment that our abilities to exercise those rights are inextricably linked.