Why is it we can find money for highways, buildings and prisons but we can't find money to help poor people with health care? It's a moral dilemma triggered by our changing times. By moral I mean as the late John Q. Wilson, a political scientist, defined it, "an intuitive, or directly felt belief about how one ought to act when one is free to act voluntarily. … By 'ought' I mean an obligation binding on all people similarly situated."
Some state leaders are now saying the state should not participate in the federal Affordable Care Act (ACA) that would expand Medicaid to provide affordable health insurance for an estimated 123,00 low income Utahns. Many of these folks are parents who need to remain healthy for their children's sake. The federal government would pay 100 percent of the cost for the first three years, phasing down to 90 percent by 2020.
According to the Public Consulting Group (PCG) study commissioned by the state health department released in May, it estimates the state could generate a $2.9 billion economic impact, create 4,100 new jobs, generate $203 million in state and county tax revenues, and save $814 million in hospital and community center uncompensated costs over the next 10 years.
So what's the problem?
After debating the matter for nearly a year, state leaders are still uncommitted. Some say they don't want to take federal money because they claim it is tenuous and Utah could get stuck with the cost of health care for poor people. The issue reveals the inconsistency in policymaking by our leaders. They readily accept federal money for buildings and highways, and are willing to go in debt for $640 million to relocate the state prison for private development, yet don't want to use federal money to insure poor people. Should that not be a moral dilemma? Is that not a matter of values, of conscience?
The dilemma is caused by the values we learned at home, church, school — to care for each other, our community and our Constitution ("promote the general welfare") that lawmakers swore to uphold. It is precipitated by the social change brought about by the technological revolution now growing exponentially. As a consequence, those policies that worked for past economies have been disrupted. In the past, employers were willing to pay for health care that covered many Americans; however, with mounting costs, the existing health programs began to diminish, and our economy has changed dramatically.
Technology has disrupted our economy where we once believed a rising tide lifted all boats. Now we have increased productivity but fewer jobs, less job security, more bankruptcies, home mortgage defaults, and we are one illness away from homelessness. Technology has created a divided society based on income, where those who are doing well seem to have less empathy for those who are struggling and see no need to change. For some of us, the poor may appear as mere statistics, yet they are an expression of who we are and how we care as a society.
Our state elected leaders are supposed to represent all people in keeping with our values, not merely a few. It's not about highways or who does what, rather how we come together to solve our problems. As John W. Gardner said, "One purpose of social change is to find new solutions that will preserve old values." That's the moral dilemma our state leaders ought to resolve.
A Utah native, John Florez has been on the staff of Sen. Orrin Hatch, served as former Utah Industrial Commissioner and filled White House appointments, including Deputy Assistant Secretary of Labor and Commission on Hispanic Education. Email him at firstname.lastname@example.org.