“You take credit card, right?” I tried to act nonchalant.
My doctor nodded even as I’m sure he wondered if I made enough to cover his $500 fee. I didn’t, but he didn’t need to know.
“Anyway, I’ll have insurance soon, and then I’ll be fine,” I said
“Which one of your jobs covers your health insurance?” he asked.
“It’s Obamacare.” My response may have required an exclamation mark.
He, however, was less impressed.
“You’re my first patient to say that.” He did after all have an office near Fifth Avenue. That should’ve been a clue.
Several days after the Affordable Care Act passed into law, French President Nicolas Sarkozy welcomed America “to the club of states who don’t turn their back on the sick and the poor.” Believe me when I say I’d rather co-write an article with Thomas Friedman than cite the former French President—but Sarkozy was right. An America with national healthcare is morally superior to one without. Having healthcare is not just meaningful; it may well mean life or death. How then to even comprehend the mindset that forbids its provision? It is, to me, a civilizing gesture. For five essential reasons.
The ‘civilized’ nature of health care
1. At least half our population at any one time cannot support itself and there cannot afford health insurance. They are called old people and new people. Not to mention how many of us are temporarily ill or otherwise prevented from work—say, because we must helicopter over said children, who so far as I can tell cannot raise themselves. Unfortunately we also need new people for taking care of us directly as family and indirectly through their economic contributions when we become old people.
2. Healthcare makes sense. Telling people to go to the emergency room is ridiculous. (I was in fact recently advised to do just that.) Hopefully it’s not so serious, this attitude says, that your illness passes, which would be especially embarrassing if the condition was treatable early on, meaning instead of becoming a dependent, you’d be able to keep working and contributing to society. Of course, this isn’t merely monetary. There are rights and wrongs in this world that transcend the balance sheet.
I must add, there is too a religious argument. Or, rather, there are many kinds of religious arguments, which shape how we behave ethically—in my case a Muslim one. “When it is said to them, ‘Spend from what God has provided you,’ those who reject faith say to those who believe, ‘Should we feed one whom, if God had willed, He Himself would have fed?’ You are in clear error!” That would be the forty-seventh verse of the Qur’an’s thirty-sixth chapter, its so-called “heart”. However, maybe some people can’t see it that way.
3. So what about sheer karmic self-interest? People who think they shouldn’t pay for other people’s health insurance don’t seem to realize that people have paid for or will pay for theirs. See also: Number 1. One of the reasons I’m able to pursue a Ph.D. is because my parents were able to provide certain educational opportunities, and one of the reasons my parents could is because the United States attracted immigrants of a certain talent.
4. Hear out Tony Judt. “We tax everyone to provide education for some. We tax everyone to provide pensions for some. We tax everyone to provide policemen or firemen from whom, at any given moment, only some people will benefit.” That’s what it means to be part of a society; otherwise the individual stands naked before capital, and will in short order be crushed. You could say that such a heartless society enjoys certain freedoms that socially democratic societies do not; then again, if you cannot leave your job for fear of losing benefits, and it would be harder for you therefore to strike out on your own, then you’re less free too. And how un-American is that?
5. If we had a social safety net, we Americans—a naturally risk-addicted species—would fall ever deeper into our dependency on innovation and change. Imagine if I had had health insurance and could write the books I always wanted to. Imagine if I had had the ability to build my pundit profile earlier than I did. Imagine if we had a more diverse and pluralistic national conversation because others who had the desire to then had the ability to so contribute their perspectives. And then?
It is a strange tension we see in American society, between our belief in freedom at home (howsoever we define that) and our utter confusion and exasperation faced with others who desire the same. What do we make of a Barack Obama who has rescued so many Americans even as he has rewarded the same Wall Street that has bankrupted so many Americans, who said he’d vote against the Iraq War even as he unaccountably expands the reach of our armies?
Of course, Obama has not—unlike his predecessor—invaded and imploded a country based not only on falsified evidence but deliberately falsified and exaggerated evidence. He has, however, overseen a worrying expansion of America’s drone war. New America Foundation, one of my previous employers, has been tracking drone strikes in Yemen and Pakistan and journalists like Jeremy Scahill help us better understand the full scale of this borderless war.
How do we square that circle?
For one thing, it is a matter of who you listen to. An ever more undemocratic America means an even more skewed national conversation. When our enabling political class is ever less reflective of our always more diverse country, it’s no wonder we see a continuation of the same policies, unchecked. For example: Why does Obama still read Thomas Friedman, who supported the Iraq War, and has yet to be ahead of the curve on any meaningful moral question?
Consider that record. The Iraq War, launched in 2003 on the flimsiest evidence, has led to tens of thousands of deaths. Add to this the cost to American lives, and the hundreds of billions of unproductive dollars we sunk into war that could have gone elsewhere—renewable energy, infrastructure, education, healthcare, scientific research—into productive and civilized causes.
This is not to mention that the most recent Iraq War came on top of an Iran-Iraq war we cynically funded, sometimes from both sides (while facilitating Saddam’s use of chemical weapons), the first Gulf War, and subsequent sanctions that exacted a terrible toll. The civil war that began after, and to a significant degree because of, our 2003 invasion, has yet to die down.
This year, more Iraqis have died than in any year since 2008.
How do Iraqis recover? Who will help them do so? Should not someone be held seriously accountable? Couldn’t we, I don’t know, offer to pay their healthcare bills? Surely we have some moral obligation to do something.
I was in the hospital the day the war started. I remember watching, tears rolling down my cheeks, in consequence both of my pain and the frustration I felt at what was happening to America and was going to happen to Mesopotamia for the second time. Iraqis, whose lives had been time and again shattered by, would be shattered all over again by sectarian war.
That time, though, I was on my parents’ insurance plan. The costs of what I went through would have otherwise ruined me.
Conscious of that, I believe in repaying the debt. Writing wrongs. Less injustice, more fairness. That, to me, is a deeper, fuller, more ethical definition of freedom—as opposed to, say, the right to die in debt, broken and alone, unable to help those who come after you, let alone those around you. To say nothing of the kind of moral worldview that seeks to empower the few by depriving the many, which claims religion, morality, and civilization, but seems to possess none of these.
Haroon Moghul is the Fellow in Muslim Politics and Societies at the Center on National Security at Fordham Law School. He is a graduate student at Columbia University, a widely-recognized speaker on Islamic thought and Muslim history, and the author of The Order of Light (Penguin 2006). Haroon's writings have been featured on Foreign Policy, Boston Review, Salon, Tikkun, Religion Dispatches, Al-Jazeera, Today's Zaman and Dawn. He is a Fellow at the Institute of Social Policy and Understanding and serves as an expert guide to the Muslim heritage of Spain, Turkey, and Bosnia. Twitter: @hsmoghul