Individual problem, collective solution?

Published 8:23 pm Tuesday, November 5, 2013

One of the most popular criticisms of the Affordable Care Act — more substantive than just pointing out the website doesn’t work — is that many Americans will now have to pay for coverage they’ll never need.

But that’s the point of Obamacare. Because if lots of people don’t pay for what they’ll never use, then others won’t get what they can’t pay for.

That’s why healthy young people must sign up, for the math to work out. And why men must purchase coverage for pregnancy.

In last week’s congressional hearing, Rep. Renee Ellmers (R-N.C.) asked Health and Human Services Secretary Kathleen Sebelius why health policies purchased by men should include maternity coverage.

“To the best of your knowledge, has a man ever delivered a baby?” Ellmers asked.

Responding to Ellmers’ question in the Los Angeles Times, Obamacare supporter Michael Hiltzik says the congresswoman doesn’t understand how health insurance works.

He claims that men should pay, in part, because we all benefit from healthy mothers and children.

“Society has a vested interest in healthy babies and mothers,” he said. “And that’s all society, because unhealthy babies and mothers impose a cost on everybody — in the expense of caring for them as wards of the public, and in the waste of social resources that comes from children unable to reach their full potential as members of society because of injuries or illnesses caused by poor prenatal and postnatal health.”

Hiltzik acknowledges that men don’t have babies themselves.

“It’s true, as Ellers observed, no man has ever given birth to a baby,” Hiltzik writes. “It’s also true that no baby has ever been born without a man being involved somewhere along the line. Limit maternity coverage only to women of childbearing age, and you’re giving many of these guys a free pass.”

That’s wrong on many levels. First, it assigns collective guilt to men in general.

By all means let’s hold men accountable for the children they father — not just for the cost of childbirth, but also for everything else that comes with bringing a baby into the world. But that’s an individual responsibility, not a collective one.

Still, Hiltzik’s broader point is entirely in line with the goal of the Affordable Care Act: Universal coverage requires universal participation.

And here’s where those who call Obamacare a “socialist program” are both wrong and right.

They’re wrong to think it’s the first step toward socialized medicine. That happened when President Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act, which said no one can be turned away from an emergency room because they couldn’t pay.

That was as pure an example of “to each, according to his need; from each, according to his ability” as Karl Marx could ever wish.

The universal coverage mandated in Obamacare is merely an extension of this principle. And that’s where Obamacare opponents who call it “socialist” are right — it’s a collective response to many individual needs.

But now, Republicans will have to acknowledge their own part in socializing our health care system.