Doing nothing does harm

In a recent interview on CBS's

Face the Nation

, Sen. Joe Lieberman argued that a public health insurance option would be a terrible mistake. It would produce higher taxes and insurance premiums, and eventually push private insurers out of business.

When asked if he would prefer no health-care reform to a public option, the independent Connecticut senator said he would. The physical, emotional, and financial harm that will surely escalate without reform - and the disparities of health and life expectancy that correlate with a person's race and ZIP code - never came up.

Lieberman's anti-reform position raises a moral question: Should the richest country on Earth value the market so highly it allows people to suffer or die because they cannot afford medical care? It is one thing to oppose health-care reform and a public option on the basis that it constitutes an un-American subversion of private enterprise. However, given Medicare's success in covering millions of senior citizens who otherwise could not afford health insurance, it is difficult to make a blanket case against a government option without more specific economic or moral justifications.

So far, most opponents of a government option rely on abstract arguments that the market is more efficient than the government, and that it is offensive to require private companies to be less profitable because they must compete with the government. But such arguments are sustainable only if one is willing to ignore or tolerate the individual catastrophes and group disparities that the private market has produced.

For example, recent studies reveal that 54 percent of the unemployed cannot afford private insurance and are not covered by Medicaid. In Philadelphia, people of color constitute a disproportionate share of the uninsured. As of last year, adult Philadelphians without private or public health insurance were 32 percent Hispanic, 14 percent black, 5 percent Asian, and 22 percent white.

While lack of insurance is not the only factor contributing to health disparities, it certainly plays a role. The uninsured in Philadelphia are half as likely to undergo standard safety screenings such as mammograms and prostate exams.

The current reform debate has let the moral question of equity out of the bottle. Doing nothing reveals a willingness to accept the financial insecurity, emotional suffering, and physical pain that 44 million uninsured people - who are disproportionately African American and Latino - continue to suffer in a market system. The disproportionate harm of the current system should be made widely known, and the decision to reform or maintain the status quo should be made with our eyes wide open.

With unemployment having stricken every part of the nation, and with nearly half of young adults and people of color jobless in some communities, continued reliance on the market to open or close the door to health care reflects a political system that is morally bankrupt. Our government's answer to the question of whether we value human beings enough to assure them minimum access to health care will reveal a lot about where our country is headed.

In the meantime, academic, health-care, business, legal, and social-service experts should work to highlight and address the significant disparities in our own back yard. Such efforts are desperately needed and simply the right thing to do.