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New law doesn’t make health coverage a right

Today at the White House, President Obama signed into law the healthcare reform bill. Towards the end of his speech to mark the occasion, Obama said: “We have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their healthcare.”

Commentators have also picked up on this theme. In an editorial, the Chicago Sun-Times concludes: “Healthcare in America is finally a right, not a privilege.”

But, unfortunately, this is not the case. For a start, the new law does not cover all Americans, and therefore it cannot be correctly referred to as “universal”. The plan calls for insurance coverage for another 32 million, adding about 10 percent of the population. However, notwithstanding Obama’s comment that “everybody” should have security, there will still be 23 million, or about 6 percent of the population, in 2019 without coverage.

Furthermore, the coverage is expanded primarily by means of mandating that most Americans must purchase health insurance. But some people are currently uninsured because they find that the cost of insurance and medical care is unaffordable, and the new law will not adequately address those costs – indeed, there is a good chance that premiums and other fees will increase. Some of the lower-paid will receive subsidies under the new plan, but there will still be sections of the “working poor” that will be stuck with an unpleasant choice between high insurance cost and government penalties for failing to buy insurance. There could be a sizeable subsection that seeks to avoid detection by the government.

Finally, a word about “rights”. True rights are fought for and earned by the population-at-large; they are not a hand-out from the elite. In the case of the new health law, there was no mobilization, no breaking down of the doors of government to insist on these reforms. And, despite the talk today at the signing, Obama did not try to sell the plan over the past year or so on the grounds of introducing universal coverage. Instead, he emphasized insurance company abuses and the need for cost control (even though the plan does not really hold down costs). It was as if Obama did not feel confident to put the case for universal coverage; and only today, safely after the law’s passage, does he adopt it as a central tenet.

Since Obama and the Democrats think the American people, thanks to the new law, now have universal coverage as a right, do not expect them to see the need to campaign for truly universal and affordable healthcare.

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