E-mail:
Jack Balkin: jackbalkin at yahoo.com
Bruce Ackerman bruce.ackerman at yale.edu
Ian Ayres ian.ayres at yale.edu
Corey Brettschneider corey_brettschneider at brown.edu
Mary Dudziak mary.l.dudziak at emory.edu
Joey Fishkin joey.fishkin at gmail.com
Heather Gerken heather.gerken at yale.edu
Abbe Gluck abbe.gluck at yale.edu
Mark Graber mgraber at law.umaryland.edu
Stephen Griffin sgriffin at tulane.edu
Jonathan Hafetz jonathan.hafetz at shu.edu
Jeremy Kessler jkessler at law.columbia.edu
Andrew Koppelman akoppelman at law.northwestern.edu
Marty Lederman msl46 at law.georgetown.edu
Sanford Levinson slevinson at law.utexas.edu
David Luban david.luban at gmail.com
Gerard Magliocca gmaglioc at iupui.edu
Jason Mazzone mazzonej at illinois.edu
Linda McClain lmcclain at bu.edu
John Mikhail mikhail at law.georgetown.edu
Frank Pasquale pasquale.frank at gmail.com
Nate Persily npersily at gmail.com
Michael Stokes Paulsen michaelstokespaulsen at gmail.com
Deborah Pearlstein dpearlst at yu.edu
Rick Pildes rick.pildes at nyu.edu
David Pozen dpozen at law.columbia.edu
Richard Primus raprimus at umich.edu
K. Sabeel Rahmansabeel.rahman at brooklaw.edu
Alice Ristroph alice.ristroph at shu.edu
Neil Siegel siegel at law.duke.edu
David Super david.super at law.georgetown.edu
Brian Tamanaha btamanaha at wulaw.wustl.edu
Nelson Tebbe nelson.tebbe at brooklaw.edu
Mark Tushnet mtushnet at law.harvard.edu
Adam Winkler winkler at ucla.edu
US v. Me: The Real Fight in American Health Care that this Debate, like all the Earlier Ones, Won't Resolve
Abbe Gluck
The GOP ACA “replacement” draft is expected
today. Chances are it will look much more like Obamacare than people might
expect.It also isn’t going to answer
the biggest question in health policy-- a question every Congress that has attempted
health care reform from FDR’s to Trump’s has steadfastedly avoided. What is
a health care system for?
If two people are dying from the same disease,
and require the same operation to survive, and one can pay and one cannot, is
it OK for the poor person to die? This is the
central question in health policy-- the tension between “social solidarity”
and “personal responsibility” (terms popularized in this context by Wendy
Mariner of Boston University), and it poses a particular problem for American
politics, because it sets upa debate between
our American capitalist ethos and our norms of equality that we all
share to some extent (even the Republican plans keep Medicaid and the ACA’s
generous insurance reforms, and Trump himself has repeatedly claimed no one is going to lose their care), but that raise entrenched concerns about socialism.
Our collective unwillingness to confront this question also has resulted in a American health care
system that is a hodgepodge of layered programs that mix public and private regulation
and that does everything in its power to hide
the government’s role in health policy. We do this-- Obamacare did this, and the current GOP plan is expected to do this, too--by running our much of our national health policy and federal assistance through insurance regulation and tax policy,
so it seems private and so remains palatable to our capitalist ethos. But make no mistake: the
government is helping most of us. Not just the poor and the elderly: anyone who
gets their health insurance from work is getting a “handout” too.
For a lot more, please see my piece out today
on Vox’s The Big Idea section.