In this paper, I aim to concisely argue that those who do not acquire health insurance must not be penalized. The Patient Protectorate and Affordable Care Act otherwise known as the Obamacare, or the ACA can be subtly described as the largest overhaul of the US healthcare system since the 1960's. However, it has remained under immense controversy since then. The act was mainly aimed at extending effective insurance coverage, to primarily the American population who lacked it. The act more specifically encompassed those not covered by their employers and the US health programs for the elderly and the poor. The act requires Americans to purchase insurance or pay the penalty at tax fee, except for those who have qualified for a limited number of exemptions. Additionally, the fees owed by the individuals, further extended to their spouse and made them equally liable. The perks of having a health insurance penalty however controversial, are beneficial in several ways: Health insurance like the Obamacare plan enables children to stay under the healthcare of their parents until they are 26 years of age, everybody under healthcare insurance is at least entitled insurance for a pre-existing medical condition, it fosters gender equality as companies no longer charge women more than men, the penalty could stop medical bankruptcies, and the right to healthcare is a necessary foundation of a just society.
However, these benefits cannot be used as a sound ground for rendering penalties to those who do not have the health insurance cover. Individuals who do not have health insurance should not be penalized for the following reasons: Not all Americans can afford the health insurance fee, forcing people with health insurance could raise taxes, many Americans do not believe there should be a right to healthcare, people should be allowed to pay for their healthcare – not being forced to have it by the government (the founding documents of the US do not support forcing people to have healthcare insurance), health insurance has undeniable flaws, and eliminating the penalty would change the individual market for the better.
Why there should be no penalties for not Having Health Insurance
Penalties deprive poor Americans the chance to keep their own hard earned money. Although the fee may not be a problem for the majority of the working population, the poor may find it hard coping with the fee. Putting a penalty on such individuals is therefore unjustified and unmoral. Most individuals would agree that purchasing highly regulated and overpriced health insurance is not the right way to spend hard earned money. The IRS reports that in 2015, over 6.2 million Americans opted to pay Obama's uninsured penalty and over 12 million individuals were exempted from it. There were also citizens who refused (without consequence) to tell IRS if they had insurance coverage or not. Most Americans would agree that after all, they can manage their hard-earned money better than the government. Withdrawing penalties on the individual mandate would put back lots of money on individuals’ and families’ pockets if they decide that they do not need the type of health insurance required by the government.
Forcing people with health insurance could raise taxes
The cost of covering health insurance in most countries where health insurance is a must is paid through higher taxes. According to Paul Gregory, forcing people to buy health insurance would make payroll rise by double the amount. Most Americans do not believe that there should be a right to healthcare. A poll conducted in 2013 by Gallup indicates that more than half of American (56%) do not believe that the federal government has a responsibility of ensuring that all Americans have health coverage.Another report released by Gallup in 2012 showed that more than half of Americans (54%) opposed the idea of a universal health coverage financed by the federal government. People should be allowed to pay for their healthcare, not being forced to have it by the government. Forcing people to pay penalties for health insurance is not justified. Taking an Insurance cover should be a person’s choice rather than being forced to have it. Penalties force hard-working individuals to pay taxes and subsidize healthcare for the unemployed. The founding documents of the United States do not support forcing people to have healthcare insurance. For example, The Declaration of Independence does not provide for the right to health care. The purpose of the constitution of the United States as outlined in the Preamble is to promote the general healthcare not to enforce it.The Bill of rights is very clear on some personal freedoms that cannot be infringed by the government. Among these fundamental freedoms is the right to life and liberty. According to Ron Paul, a Congressman, every individual has the freedom to keep what they earn in a free country.
Christianity and Judaism
Christianity considers compassion a foundational component – suffering is a result of injustice. Christianity would consider the suffering of a person due to a lack of health insurance a moral problem (if you consider the human soul to be a part of the body). Christianity might consider a lack of free universal health insurance to be a problem as well as penalizing those who cannot afford health insurance. If mercy is a value of Christianity, charging outrageous amounts to Americans who cannot afford coverage or see the lack of necessity in healthcare is unethical because everyone deserves respect, “love thy neighbor”. Christianity would disagree with expensive costs and treatments for the oppressed and vulnerable people of society. I am going to make a moral analysis of Christianity and the penalties of healthcare using the liberation method. The liberation method involves preventing, whenever possible, the diseases that affect people. To do this we must acknowledge the scandalous living conditions of those living in poverty. If we know that struggling impoverished and middle-class individuals who cannot afford healthcare and cannot chose to opt out of healthcare plans due to penalization are trapped in a cycle of marginalization and discrimination– these people have not yet been liberated. According to Christianity, an effective solution for the liberation of humans is to heal the sick and to reject the comforting relativism that keeps us complacent in our actions. The focus should be on the compassionate treatment of all, penalization for lack of ability to pay or rejection due to belief is not compassionate treatment.
Health insurance has flaws
A ruling by the Supreme Court in 2012 found ACA constitutional but highlighted major flaws stating that the administration of government health program Medicaid had to be changed by the states. Since only a few Americans have welcomed the health Insurance cover, insurance companies are backing out of participating in the cover. A good example is the Obamacare plan. Obamacare, otherwise known as the Affordable Healthcare Act is a required health insurance that is supposed to affect the health of the American people in the long-term by making insurance more affordable, especially those who do not receive insurance through their jobs or have costly pre-existing conditions. Before the ACA, insurance coverage could be denied because of pre-existing conditions – say you were just diagnosed with stage-four breast cancer and because of sickness you lost your job, an insurance company could decide that your cost of treatment would be too much and cancel it. With the ACA, the limits on care and benefits due to cost has been eliminated as well as the rescissions made by insurance companies that would terminate coverage because of a patient’s illness. However, controversy remains because if you do not purchase the ACA you receive a fine as, well as, an increase in tax costs for middle-class Americans who have already purchased private insurance.
Benefits of Having Health Insurance Penalty
The right to healthcare could help save lives. Research shows that a lack of healthcare insurance has played a major role in many deaths witnessed every year. Steffie Woolhandler, a professor of medicine, and a primary care physician at Cambridge Health Alliance notes:
“Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”
Health insurance is helpful in many cases of medical injuries and help alleviate the full costs of medical bills. Research also shows that people with health insurance cover live longer than those without. Andrew Wilper, M.D., a professor at the University of Washington School of Medicine states:
“The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health, we doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”
Judaism
Judaism might consider the health insurance penalty to be beneficial to health of human beings. Considering certain Jewish bioethical principles such as: the interpretation of law matters as a process and an outcome (consulting the Halakha before making an important biomedical decision), the emphasis that life is valuable (saving a human life is the ethically best thing you can do), the avoidance of suffering, and the emphasis that your life does not belong to you. Opting out of health insurance could be considered as causing yourself suffering as well as threatening your bodily integrity – thus making a penalty justifiable. It is also possible that Judaism would consider the health insurance penalty immoral because freedom is prerequisite for obedience, if health insurance is not required but you are penalized after you choose not to purchase an insurance plan there is no freedom in this choice. I am now going to examine the issue of the health insurance penalty through the casuistry method. Casuistry is a type of reasoning for cases that involve moral dilemmas. When using the casuistry method, we must assume two things: natural law and a community of prudence. The health insurance penalty, according to casuistry could be considered unethical because it places a monetary value on life. However, Jewish casuistry is grounded in the belief in the sanctity of life which might consider the health insurance penalty plausible because it reinforces the idea that your life is not your own, so if you deny health insurance an receive a penalty it would be justified with the idea that it is necessary to protect a human life at all costs even if it includes an incentive to receive preventative care treatment.
Public Health
A right to healthcare improves public health. The Health Insurance Penalty would give people a right to healthcare. Evidence suggests that this would lead to better access to necessary healthcare and improved population health more so for poor people. A 2008 peer-reviewed study showed that majority of uninsured working Americans had chronic conditions like the heart disease and their lack of insurance was behind their less access to care, early disability, and even death. The penalty could stop medical bankruptcies. Research shows that approximately 62 percent of all US bankruptcies were linked to the medical expenses. Forcing all US citizens to purchase health insurance would help eliminate the potential bankruptcies. As, the right to healthcare is a necessary foundation of a just society, within the United States, we already have public law enforcement, public road maintenance and other law enforced services aimed at promoting a just society. Adding healthcare insurance to the list would only be a routine way of ensuring a just society. According to N. Daniels, health care sustains people and ensure that they remain active in the in the political, social and economic life of the society. Many Americans develop illnesses that are beyond their control, for example, if you are living in poverty and cannot afford healthy nutritional foods or have to support a family before you can support yourself your body’s immune system would lower – if you cannot afford preventative care and smaller symptoms and ailments can develop into larger more expensive diseases. For chronic illnesses, the high costs are usually too devastating and because of this the death toll raises. If the impoverished are dying from illnesses that could have been prevented with simple life-saving treatment than it is a societal problem. The unjust refusal of basic healthcare poses a problem to how our society decided who deserves to live and die. This should not be the case.
Resolution
Having penalties for not having health insurance has a few benefits. Some of these include saving lives, improving public health, stopping medical bankruptcies and establishing a just society. However, these benefits are not enough for penalizing those unable to afford the cover or they just have a better use for their hard-earned money. By eliminating penalties people would still be able to access benefits from healthcare, while making it more approachable and affordable. It is detrimental to the idea of having healthcare insurance to force someone to pay for insurance, and when they do not pay for it, to then penalize them further. In many cases people cannot afford the insurance, let alone the penalties, so when they are told that it is mandated, instinctively they are opposed. This could be the cause of over half the Americans in polls taken responding that they felt that the Federal government was overstepping by requiring universal healthcare.