From every ethical perspective I can think of, there is no justification for a system that makes health care better for people who can pay for it than for people who cannot.
From the perspective of principle, each person’s well-being is of equal value. I think it goes deeper than this: each is of sacred worth. From the perspective of consequences and virtues, limiting peoples’ access to quality health care only makes a society sicker. The moral sickness sets in before the physical sicknesses do.
Most countries with whom ours compares itself understand this. And their health care systems are the better for it.
Now that “the individual mandate” has been upheld by the Supreme Court, the Affordable Care Act just might survive. We may even be on the verge of making real progress toward creating a health care system that includes universal access, more choices, and lower costs.
What will make the progress more difficult than it needs to be, though, are political and ideological declamations like the following:
(1) This country cannot afford further expansions of health care. There is a way to make this proposition a morally serious one: sound arguments that we cannot support health care for the chronically ill, the poor, and children of the poor without putting at risk causes of greater value. So far, however, I haven’t discovered any.
(2) That government is best which governs least. In today’s debates, this maxim decodes roughly into something like: I don’t want your benefits to cost me any of mine.
(3) President Obama is wrong about everything, all the time. There may be some truth to this proposition. By my calculation, however, it would be roughly equal to that of all the propositions to the contrary.
(4) The time has come for every American to acknowledge that we cannot do everything that we want to do. Every American I know already acknowledges this. Nevertheless, the moral question still remains: if our society cannot provide optimal health care for all its citizens, then what should we do instead?
In spite of the seeming unwillingness of many government leaders across the political spectrum to acknowledge it, health care is a moral, even if not easily affordable, imperative for any society at all times and everywhere. For our society, keeping people healthy is indispensable to ensuring their rights to life and the pursuit of happiness.