Beyond Obamacare: 5 opinions on health care reform

Health care reform remains a contentious issue in the United States. The Supreme Court upheld the constitutionality of President Obama's health care law, the Affordable Care Act, known as Obamacare. But some Republicans, like presidential hopeful Mitt Romney, hope to repeal the law under the next Congress. Here, writers explore five key aspects of health-care reform.

4. Barrier to better health care: Republican definition of freedom

Anthony L. Schlaff, director of the Master in Public Health Program at Tufts University School of Medicine, claims: “If traffic lights were invented today, the Republican Party would be against them.” He continues: 

After all, aren’t traffic lights a perfect symbol for government imposition on individual freedom? The government takes our money to build and maintain them, and then uses them to tell us when we can stop and when we can go. But anyone who drives in a city knows how necessary traffic lights are.

Schlaff explains how this “thought experiment” applies to Republicans’ objection to the individual mandate in the new health-care law:

Freedom is about rights, choices, and opportunities. As with traffic lights, [government action] can enhance freedom, and we need to be thoughtful, not reflexive, in how we view what we ask of government.

Schlaff asks:

How many of us want the freedom to face medical bankruptcy, or the freedom to be denied coverage (and care) because of a preexisting condition? And how many of us see dying, due to lack of insurance, from a treatable or curable disease as an acceptable cost of individual liberty?

As with traffic lights, there is a trade-off; we cannot get something for nothing. The only way to have a system that guarantees necessary care for those in need – to give us the freedom to live our lives without that fear – is to make sure everyone is included in the system.

He argues: “We need to take back the meaning of freedom from those who cheapen it with simplistic bromides.”

According to the simplified notion of personal responsibility, people should take it upon themselves to get educated, keep their water clean, and properly dispose of household waste. It sounds good in theory, but would you live in a town that had no schools, and no water or sewer treatment, but gave every household the “freedom” to manage these concerns on their own? Probably not.

Schlaff concludes:

Thankfully, citizens across America have the freedom – through government – to manage these problems collectively. A century ago, that is what they did, and we are all the freer for having school, water, and sewer systems run by our cities and towns. 

Anthony L. Schlaff, MD, MPH, is director of the Master in Public Health Program at Tufts University School of Medicine. The views expressed here are his own.

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