Health: Inherent to Life, Liberty, and Pursuit of Happiness

We urgently need a bipartisan consensus to achieve and implement a quality and sustainable health care system for all Americans on a par with health care systems of other high-income economies.

Life, liberty, and the pursuit of happiness are enshrined in the Declaration of Independence and in the American think-big, can-do spirit. Health is the sine qua non for accomplishing all of these and is essential for longevity and quality of life. Health at both the individual and population levels is an invaluable asset for economic and social development and for sustaining robust economies and democracies. Health is also essential to a nation’s security and prosperity.

While the Obama administration’s Affordable Care Act (ACA) was an imperfect piece of legislation, in need of revision and fine-tuning, it has nevertheless made health care accessible to millions of Americans who did not have such access to care. The American Health Care Act (AHCA), introduced by the Trump administration last month and withdrawn because of insufficient votes to pass it, would have reversed this enhanced access to care for many Americans. The Congressional Budget Office had projected that under the AHCA, 24 million Americans would have lost access to health care over the next 10 years.

It is clear that the U.S. health care system needs to be reformed. According to the Centers for Medicare and Medicaid Services, health care spending in this country grew 5.8 percent in 2015, reaching $3.2 trillion, or $9,990 per person. As a share of the nation’s Gross Domestic Product, health spending accounted for 17.8 percent. In 2014, the Commonwealth Fund reported that among the 11 high-income countries it studied, practically all provided access to health care to all their citizens for lesser budget allocations, and their health systems’ performance, in aggregate, were superior to that of the United States on all indices, inclusive of access, quality, and sustainability.

In the 2018 Congressional elections, we hope the candidates will put Americans first; rekindle the American tradition of the think-big, can-do spirit; apply that innovative, winning spirit to authentic health care reform; emulate the bipartisan example of President Ronald Reagan and Speaker Tip O’Neill; accept that American exceptionalism may also learn from other health systems how to best achieve total health care for all across the life cycle; and work together for our country and our people to update and build upon the ACA or present an enhanced, bipartisan alternative.

Eliot Sorel, M.D. (Washington, D.C.) ■