Those in favor of systemic healthcare reforms will tell you that our current healthcare system is unfair. A June 6, 2009, NY Times editorial noted, “to abandon the goal of universal coverage…. would be unfair to the 46 million uninsured Americans….”
It’s time to pause and define our terms as we consider what kind of national healthcare system we want in this country, and the forthcoming August Congressional recess gives Congress and Americans alike that very opportunity.
At issue is the difference between EQUALITY and FAIRNESS. Our common American interest in equality stems from one of the best known phrases in our founding documents: “We hold these truths to be self-evident, that all men are created equal….” Equality, as noted here, does not guarantee equality of experience, but rather equality of opportunity. All men are CREATED equal, the preamble to the Declaration of Independence says. This is a declaration concerning the immutable value of every human citizen and a promise of opportunity unconstrained by prejudice, not a promise concerning quality of life.
The attendant rights associated with this valuation of human life are that all men “are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness” (not prosperity, housing and healthcare). Our unalienable rights deal with the process of the American experience. There is no promise of success or guarantee of reward. What we are granted, as Americans, is EQUALITY OF OPPORTUNITY, not equality of experience. Governments established on the precepts of equality of experience are defined as communist—the sharing of collective resources for the utilization of the group. Is equality of experience what we want in America?
Is it UNfair that some Americans have health insurance and some do not? It is UNFORTUNATE, but it is not UNFAIR. What’s UNFAIR is the current financing mechanisms under consideration in Congress for healthcare.
Is it fair that someone would study hard and get good grades in high school so that he can go to college, where he studies hard and gets good grades so that he can get a good job with health benefits, and then to have his salary taxed so that those who have squandered those same opportunities might have EQUAL benefits? These Robin Hood economics are fundamentally UNFAIR. Fairness would ensure equal reward for equal investment. What Congress is considering is equal reward for disparate investment.
The United States has many problems and is not without its faults. Yet many, many citizens find ways to take advantage of the opportunities they are afforded. A free, appropriate public education is afforded to all American children. Thousands of youths every year, in the very worst public schools, are able to work hard and use the education they are provided to get into college where new opportunities await. Meanwhile, many of their peers choose to be victims, forfeiting the opportunities they have because they perceive their opportunities aren’t equal to opportunities afforded to other segments of American society. Notwithstanding the veracity of the latter, the real shame is that they cannot see what they’re forfeiting. Yet, as adults, these same individuals cry out because they do not have benefits that others have. They do not have those benefits because they have not earned those benefits.
No one wants life to be fair; they want it to be unfair in their favor. Any future healthcare system should perpetuate the historical American understanding of EQUALITY and FAIRNESS—what is FAIR is that all Americans have equal opportunity. Ensuring equal access to a system that provides incentives for hard work and disincentives for sloth is in keeping with American values. There should be varying degrees of healthcare coverage to reflect the vary degrees of investment individuals make in obtaining those benefits. There should be extra reward for extra work.
As it turns out, the fairest system is also the least equal. I’m comfortable with that.