Should only those able to pay have decent health care?

AntiPovertySoldierIn January of 1944, President Franklin Delano Roosevelt delivered his penultimate State of the Union Address before the United States Congress. It was during this address that President Roosevelt proposed an Economic Bill of Rights, or what officially has come to be known as the Second Bill of Rights.

Roosevelt’s proposal specifically laid out eight economic rights that he believed should be guaranteed to all Americans, which included the right to a living-wage job, food, education, housing, social security, and health care.

Of this vision, Roosevelt proclaimed, “It is our duty now to begin to lay the plans and determine the strategy for the winning of a lasting peace and the establishment of an American standard of living higher than ever before known. We cannot be content, no matter how high that general standard of living may be, if some fraction of our people — whether it be one-third or one-fifth or one-tenth — is ill-fed, ill-clothed, ill-housed, and insecure.”

Although his plan for an Economic Bill of Rights never came to fruition, it would later influence future legislation in the United States as well as the adoption of the United Nation’s Universal Declaration of Human Rights in 1948. And yet, just as Roosevelt’s New Deal had done more than a decade before, his proposed Economic Bill of Rights caused immediate controversy in several circles and fostered a partisan political debate that continues to this day.

I don’t have any intention of using this column to participate in that debate, nor do I seek to discuss constitutional law or the appropriate role of government. I do however want to address the issue of health care, which is one of the eight rights that were set forth in Roosevelt’s plan for a new Bill of Rights for all Americans.

One of the first things that come to mind as related to this issue is a quote from the Irish activist-rock star Bono, who once said that “Where you live should not determine whether you live, or whether you die.” Of course, this statement was largely in reference to the global crisis of extreme poverty, which affects nearly three billion of the world’s people. Nonetheless, it can just as easily be applied to the United States where nearly 50 million citizens live in poverty and another 100 million are economically insecure.

I have a difficult time understanding how anyone in good conscience could possibly believe that one’s ability to pay for medical care should determine whether or not they have access to such care. And although the number of uninsured Americans has been significantly reduced in recent years, for many living in poverty even with health insurance, the out-of-pocket costs are causing a considerable burden.

Not too long ago, the MSR published a thought-provoking editorial aptly titled, “Poor people too poor to pay medical copayments.” In its editorial, the MSR noted that those in poverty, particularly the 20 million Americans living in deep poverty (with incomes below 50 percent of the federal poverty line), are struggling to keep pace with even modest increases in medical costs as well as insurance premiums, copays and other fees.

Recent reports, including one from The Commonwealth Fund, suggest that rising healthcare costs are further contributing to the increasing income gap in the United States. Plus, an additional story from The Commonwealth Fund, which cites a report by the US Census Bureau, finds that if healthcare costs were figured into the formula to measure poverty, approximately 10 million more Americans would officially be categorized as poor. This figure includes two million children and another three million seniors.

We have all probably heard stories about the parents of small children choosing whether or not to buy food or pay the electric bill. Likewise, many of our eldest citizens on fixed-incomes are often faced with the absurdity of having to decide on whether to buy food or medicine.

Poverty cannot be the reason that our most vulnerable populations don’t have access to health care. As the late Hubert H. Humphrey once said, our greatest moral test is how we “treat those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.”


Clarence Hightower, executive director of Community Action Partnership of Ramsey & Washington Counties, holds a Ph.D. in urban higher education from Jackson State University. He welcomes reader responses to 450 Syndicate Street, St. Paul, MN 55104.