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COMMENTARY: Gay marriage more popular than Obamacare?

When the U.S. Supreme Court ruled on the Affordable Care Act last week, I found myself in the perfect laboratory of national opinions, surrounded by families, businesspeople, and gay flight attendants all passing through Atlanta’s Hartsfield-Jackson airport.

As CNN announced the breaking news that the Supreme Court had left the Affordable Care Act standing, passengers waiting for flights started speaking out:

“There goes the middle class,” groused a guy behind me.

“Now we know what we need to do — get that guy (President Barack Obama) out of office,” snorted a woman sitting with her elderly mother.

“This is why our forefathers left England. It’s socialism!” insisted a history-challenged senior.

Right now, more Americans have come around to accept gay marriage than are in favor of the Affordable Care Act (ACA), aka Obamacare. What’s behind this virulent hatred of a national healthcare program?


Now, I’m not saying that there aren’t legitimate concerns about the ACA in its current form. We can have a good debate about the details of its roll out. But first let’s put some common arguments to rest.

“The U.S. has the best healthcare in the world.”

Not if you agree that healthcare should prevent untimely deaths. The U.S. is in eighth to last place in the industrialized world when it comes to life expectancy. The only relatively developed nations we outlive are the Czech Republic, Estonia, Hungary, Mexico, Poland, Slovakia and Turkey. We rank dead last amongst highly industrialized nations. Not exactly what you would expect for the third wealthiest country in the world with the “best” healthcare.

“We just can’t afford universal healthcare.”

We’re already paying the price tag for universal healthcare, just not getting its benefits. The U.S. pays 2.5 times per person as much for healthcare as the average for all other industrialized nations. Pre-existing condition exclusions blocked many Americans from getting health insurance, and high premiums still block others. So many of the 50 million uninsured Americans use the emergency room as their primary healthcare provider.

The average emergency room visit costs $1,318, or $1,565 for patients over age 45. Worse, by the time uninsured people get to the ER, their conditions are much more costly to treat. For example, we spend more than any country in the world on hospital admissions for preventable diabetes. When patients can’t pay, you and I are already picking up the tab through increased insurance premiums, and increased taxes as hospitals write off their losses.

“Well, we don’t want to be like Canada, with its rationed healthcare, or socialist like France!”

Agreed, we’re an innovative capitalist country. But since we’re paying more and getting less for our healthcare dollar, just saying “no” to “socialist ObamaCare” isn’t good enough. Let’s borrow a better business model from one of the industrialized nations that has a successful healthcare system without resorting to universal healthcare. Have you got a country in mind? If you do, you must have gone back in time, because ever since Israel changed its system in 1995, we’re the only nation in the industrialized world that does not have universal healthcare.

That’s right, it’s not just Canada and France that have universal healthcare, but also Australia, Austria, Bahrain, Belgium, Brunei, Cyprus, Denmark, Finland, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Kuwait, Luxemburg, New Zealand, the Netherlands, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the United Arab Emirates and the United Kingdom. And they all pay less per person, and all live longer, on average, than we do.

Not a single American I’ve spoken to who is opposed to the Affordable Care Act knew this most basic fact. Too often, they’re getting their news from the same sort of polarizing instigators who also warn about the evil “gay agenda.”

The truth is, we can’t afford not to have universal healthcare. Among those employed, medical expense is the number one cause of household bankruptcies in the U.S. You can sock away savings all of your life, but when genetics, age, bad habits or bad luck bring a major medical issue to your home, too often all financial reserves are lost.

So go ahead and call universal healthcare “socialism.” I believe government has two core functions. Defend the nation’s people against enemy attack, and defend citizens from unnecessary death. No town buys its own tank and jet fighter for a possible war, and very few households could save up enough for a medical catastrophe. This is why societies have governments in the first place, not just socialist governments.

Take it from Mitt Romney, who supported an individual mandate to establish universal healthcare in 2006: “Folks, if you can afford health care, then, gosh, you'd better go get it. Otherwise you're just passing on your expenses to someone else. That's not Republican, that's not Democratic, that's not Libertarian. That's just wrong.” Sticking stubbornly to our broken, privatized model is just plain wrong.

Stephen Fallon is the president of Skills4, a healthcare consulting firm in Fort Lauderdale, Fla., that provides services to CDC and HRSA funded providers, primarily gay- or minority-based agencies and clinics.