While various faith based organizations, political conservatives and deficit hawks bemoan the Supreme Court’s ACA decision, I look around and wonder what they cannot apparently see. From my perspective, the current healthcare system creates a division that encourages instability, weakness, and vulnerability. In short, if you’re poor, uneducated or have no insurance, your pretty much classified in the ‘screwed’ section.

For instance, on a Sunny day in October for 2011, over 3,000 people in Los Angeles waited in line for a little known and little reported event: a chance to get free medical care in a massive temporary clinic. In March of 2012, hundreds of uninsured and underinsured waited near the Oakland Coliseum while Hundreds gathered on June 23rd at the “Care 4 the IE” free healthcare fair at the National Orange Show Events Center. Similar events occur across the nation.

Prior to the Affordable Care Act, quality medical care for low income and rural communities is hard to locate. As technology pushes mainstream urban hospitals toward the future, consistent medical care in rural America leaves a lot to be desired.  Recent studies estimate approximately 50 million Americans living in rural America has little access to consistent primary care.

Regardless of one’s viewpoint, there are positive benefits of the ACA healthcare reform. Just to name a few:

  • Insurance coverage for children with pre-existing conditions and the creation of a national high-risk health insurance pool to offer coverage to adults with pre-existing conditions.
  • New resources will help provide health care professionals with tools needed to improve health care quality, reduce errors, and decrease costs.
  • Rural communities will receive investments in telehealth technologies that will enable rural areas to access the care of physicians outside of their local community, increasing the range of services that are accessible.
  • The ACA supports the training, education and placement of thousands of new primary care providers for small towns.
  • Makes it easier for rural doctors to serve their communities, it increases Medicare and Medicaid reimbursement rates and expands the capacity of Community Health Centers.

Resources are finite and our society does provide healthcare to those who haven’t cared for themselves.  Being a Buddhist, even I struggle with ethical choices made at the community level. Our own personal actions cause tremendous strain of available resources. We eat too much, do not exercise properly, miss various medical checkups and do not accept personal responsibility for the lives’ under our direct care. Basically, as individuals (including myself), our personal healthcare compass sucks.

Thus, the hard question is, should we refuse treatment? Should we deny healthcare to a rich man who can afford healthcare services but abused his body versus a poor man whose health suffers simply because he couldn’t eat? If we deny such patients, can we claim to serve the whole? In other words, is healthcare a ‘right?’ And if so, is there a greater perceived right in a metropolitan area versus a rural area?

Regardless of our own personal choices, I know the existing healthcare system determines who gets what. And as I travel the highways and backroads of rural America, one thing is clear: poverty is the great arbiter that hinders one’s access to quality health care. Thus, the poorer one is, the greater the barrier to quality medical care. If you’re rich, you’re in. If you’re poor, you’re allocated a lifetime of bare-bones, basic at best.

Like a teen going through puberty, the ACA has many pimples. Yes, the ACA has an individual mandate. Yes, there is a ‘tax’ for those who choose not participate. Yes, health plans may have to cover levonorgestrel and potentially other contraceptives. But simply repealing the ACA is not an answer and would force many rural Americans to skip preventative care; thus increasing both health problems and costs in the long run.

From my own Buddhist viewpoint, the ethical principle of social justice is important. All of us have a moral obligation to ensure fiscal stinginess on our part does not result in the unnecessary loss of human life. As a Buddhist, we have a moral obligation to ensure income level is not a sole barrier to access of quality health care.

The famous quote “Laws are like sausages, it is better not to see them being made” definitely applies. Rather than entrenching political positions, can’t we use this time to mold, craft and mature the law into something everyone can live with?  If we repeal progress, we must be prepared to answer the questions of what we would do different … today!