An issue that needs discussion

Watching the Republicans try to figure out what to do about health care makes it clear that we as a nation haven’t come to terms with a basic question: just how much should government (ie- taxpayers) do for a citizen, especially one who is poor.

Clearly we don’t expect the government to provide every citizen with a car or a TV set or Rolex watch or a paid vacation if they can’t afford to buy it themselves.

But as a nation we have already decided we will provide a minimal senior safety net in Social Security, BUT only to people who put into the system for at least 10 years (40 quarters), and only roughly in proportion to how much they put in.  And as a nation we have already decided the nation owes each young person the opportunity for a free education up through high school, though the quality of that education in fact varies widely.

We have also agreed as a nation to supplement the wages of low wage people with the earned income tax credit, BUT this in only available to people who are working – who are at least trying to make a living wage. And the same with jobless benefits – in theory only available to people for a limited time, and only so long as they are – or at least appear to be – looking for work.

So where does health insurance fit in to this? Do we, the taxpayers, owe everyone a subsidized health insurance plan, whether they can pay for it or not? For that matter, do we the taxpayers owe everyone health care, no matter their circumstances? Even expensive health care for people who have chosen voluntarily to ruin their health with smoking or drugs or junk food?

This is a fundamental question, and much of the emotional turmoil around ObamaCare and its replacement is because we as a nation haven’t really come to terms with this question. Liberals think in theory that the government (ie, the taxpayers) owes everyone health care, whether they can afford it or not, though they are far less eager to raise taxes enough to actually pay for it. California is about to propose universal health care for its citizens, but the cost is astronomical (estimated at $400 billion per year, for a state already running an estimate $1.6 billion budget deficit this year!).

Conservatives in contrast believe in individual responsibility, and feel that people who are feckless enough to be poor and/or out of work have only themselves to blame if they can’t afford health care or health insurance. But of course not all the poor are feckless or jobless by choice.

Neither of these positions is really reasonable. Liberals live in a never-never land where “someone else“ (usually ”the rich”) are going to pay for their expensive social programs.  Conservatives are blind to the realities of poverty and joblessness in our culture. And then there is the question of the young – tomorrow’s citizens and workers and leaders. Those living in poverty are not doing so because of their own faults or career choices, and the nation as a whole will suffer if they are poorly educated and poorly prepared to contribute to the economy when they reach adulthood.

I don’t have an answer or a position on this issue, but clearly neither does either political party, which is why the current highly emotional debate about the Republican health care proposal is essentially meaningless – it won’t become meaningful until we resolve the underlying issue of just how much, as a nation, we think we owe the poor and people who can’t afford the basics of life, and how much we the taxpayers are willing to pay to provide that support.

And that is a complicated subject, because there are lots of reasons people are poor – some are poor through their own their own fault and some are poor because of circumstances outside their control. Do we treat both groups the same? How do we differentiate the groups? Is our responsibility as a nation different for these two groups?

This is where the national debate ought to be centered, not on the meaningless political one-upsmanship going on in Washington today.