Lack of Solidarity in Health Care – Reflections on a NY Times Op-ed

Here is a great example of how the health care debate is finally beginning to inspire more thoughtful reflections and critiques – possibly informed by human rights advocacy – at the same time as dominant policy proposals continue clinging to the status quo. In particular, an opinion piece by Roger Cohen ("The Public Imperative") at the New York Times explains some of the ideological obstacles to realizing the right to health care in the United States, yet disregards the growing grassroots movement for rights-based health care principles and their potential implementation through single payer policy proposals. Here is the crux of the argument:

“Europeans don’t get why Americans don’t agree that universal health coverage is a fundamental contract to which the citizens of any developed society have a right. […] Fixing [the US health care system] requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society. Europeans have no problem with this moral commitment. But Americans hear ‘pooled risk’ and think, ‘Hey, somebody’s freeloading on my hard work.’ […] [Europeans] see greater risk in unfettered individualism than in social solidarity. Americans, born in revolt against Europe and so ever defining themselves against the old Continent’s models, mythologize their rugged (always rugged) individualism as the bulwark against initiative-sapping entitlements. We’re not talking about health here. We’re talking about national narratives and mythologies — as well as money. These are things not much susceptible to logic. But in matters of life and death, mythology must cede to reality, profit to wellbeing.”

This is a welcome analysis of a key barrier faced by those struggling for the right to health care in the U.S. today. It highlights how the national ‘mythology’ of individualism can undermine the fight for vital services that can only be provided collectively. The article goes on to note how some measure of solidarity seems particularly pertinent and plausible when it comes to health – if Americans share nothing else, they surely can agree that unnecessary sickness and death are what everyone wants to avoid and no one deserves.

Yet Cohen is less clear on how mythology and money are intertwined to form a powerful hegemony that is, in fact, not at all representative of the public will, as documented in protests movements, opinion polls, daily letters to the editor, and even, yes, elections. We see more support for rights-based reforms, such as single payer national health insurance, in the public sphere than in the hallowed halls of Congress, where myth and money seem to go hand in hand to keep things the way they are. Our representatives have not yet recognized that, as Cohen says, “health care is a moral obligation rather than a financial opportunity”. Therefore, we should not indulge them by narrowing the discussion to their small-minded policy options. A “clear moral stand” must be based on firm human rights principles that do not allow excluding people from health care based on their ability to pay, their immigration status, or any other factor. This is the principle of solidarity we promote, and it must be the solidarity we practice.

Read the full op-ed by Roger Cohen here. In addition Nicholas D. Kristof, also from the New York Times, expresses his views on health insurance in an op-ed titled "Let Congress Go Without Insurance." Read it here