Thursday, January 26, 2017

The ACA Has Achieved Something Significant

Five Year Old James Cook of Cleveland, Ohio

When he returned to Capernaum after some days, it was reported that he was at home. So many gathered around that there was no longer room for them, not even in front of the door; and he was speaking the word to them. Then some people came, bringing to him a paralyzed man, carried by four of them. And when they could not bring him to Jesus because of the crowd, they removed the roof above him; and after having dug through it, they let down the mat on which the paralytic lay. When Jesus saw their faith, he said to the paralytic, “Son, your sins are forgiven.”

“I say to you, stand up, take your mat and go to your home.” And he stood up, and immediately took the mat and went out before all of them; so that they were all amazed and glorified God, saying, “We have never seen anything like this!”

Mark 2:1-5, 11-12

Modern readers tend to focus first on the miracle.

They may believe it literally, or they may see it as a metaphor. They may rationalize it, or they may see it pointing toward larger truths about healing and wholeness and forgiveness, they may focus on sin and guilt in relation to physical health.

But there is something else, central to the story, which is easily missed. What impresses Jesus is the four friends carrying the paralytic. “When he saw their faith” he offered the forgiveness that led to healing.

They picked him up and carried him.

When Jesus saw them carrying the man, he called that “faith.”

Over the past eight years of our national debate about the Affordable Care Act, one of the most contentious questions has been about whether or not healthy people have a responsibility to carry those who are ill.

And the good news is that we have made progress.

In September of 2011 CNN anchor Wolf Blitzer was moderating a Republican Presidential Candidates debate in Tampa Florida. He posed a hypothetical question to Dr. Ron Paul. If a healthy thirty year old man with a good income chose not to buy health insurance and then became catastrophically ill, what should happen? Paul tried to dodge the question by recalling (incorrectly) that years ago the churches took care of people who had no insurance, but a significant portion of the audience could be heard chanting, “Let him die! Let him die!”

Not our finest moment, though the Ayn Rand crowd must have rejoiced in the triumph of “the virtue of selfishness.”

No one is really happy with the individual mandate requirement of the Affordable Care Act. But without some means of requiring everyone to buy coverage it is impossible to pay for the very popular provisions protecting those with pre-existing conditions and eliminating the lifetime limits on coverage.

The ACA is far from perfect. But it has achieved something significant. It has shifted the terms of the debate.

When we first began discussing the ACA, one of the primary objections was that “we can’t afford it.” In other words, we won’t carry sick people. If people need to be carried they will have to pay for it on their own.

In the initial debates and in subsequent attempts at repeal, those against the ACA did not mention the folks without health insurance. And they did not seem worried that repeal would take away insurance from twenty million people who were previously uninsured and now have health insurance through the ACA.

But now that has shifted.

President Trump’s official position is that the ACA should be repealed and replaced with Health Savings Accounts, which is not really a viable alternative to insurance. But in his public statements he has repeatedly said that we can’t have twenty million people losing health insurance. And other opponents of the ACA have said the same thing.

In the long run we need some version of single payer health insurance like almost all of the developed world. And we could do this using the present Medicare model.

But for now at least we seem to have taken a small step toward.

Thank you for reading. Your thoughts and comments are always welcome. Please feel free to share on social media as you wish. 

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