When I once consulted in the healthcare field, I had a colleague who was fond of saying, “Everyone is entitled to crappy healthcare.”  

This simple statement included two very important points.  

The first was that access to healthcare is a human right – not something just for those who can afford it. The second was that there is a big difference between the “must have” and “wants” in standards of care, and this difference shows up in the cost of healthcare.

For those of us who do not get healthcare insurance from our jobs, the new year brings shockingly higher costs for insurance purchased through the government marketplace established by the Affordable Care Act. 

In a recent column, I made reference to a friend who will now have to pay an increase of $600 a month for less insurance than they had last year.

This increase is due to Congress’ inability to extend tax credits and other financial help for people who purchase healthcare insurance on their own.  Our recent government shutdown was due in large part to Democrats wanting an extension of this financial help and Republicans wanting to try something different (without any specific details or timeframes).

I see two fatal flaws in the Republican ideology as it relates to healthcare.  The first is that they insist on the private sector driving healthcare insurance and delivery. If you believe healthcare access is a human right, then you believe everyone – without exception – should be able to access the care they need.  

The private healthcare sector operates to make money by providing healthcare products and services.  This means that if insurers and healthcare service providers cannot make money then they don’t want to provide the service. Can you see the incompatibility?

The second fatal flaw is that Republicans want to make healthcare more affordable for the government, not you. This is why they want to get government out of the business, without any specific plans for how to make the private sector meet all healthcare needs as a human right.  The Affordable Care Act, or “Obamacare,” was an important first step to protect this human right. 

Remember, “for profit” businesses don’t want customers for which they will lose money. 

So why was my friend championing crappy healthcare for all? If you ever watch old TV episodes of MASH, you always see a tent full of soldiers, laying on Army cots, recovering from their injuries. Those soldiers have access to everything their standard of care requires – doctors, nurses, surgeries, medications, wound care, and food.  What you don’t see are private rooms, adjustable beds, TVs, internet services and a chef’s menu.

By our standards, the soldiers received crappy healthcare yet they received everything they medically required.

President Obama’s book “A Promised Land” is insightful into the ongoing conflict our government is stuck in with regard to healthcare. There is only one way to satisfy the human right of healthcare in an affordable manner.  Our non-profit government can provide universal “crappy” healthcare to all.  It will be affordable because it will provide only medical necessities and no luxuries.

At the time the Affordable Care Act was passed, the idea of universal healthcare was considered a bridge too far to pass. So, this act was compromised by trying to meet the human right through for-profit private insurers and providers, thus the kluge everyone likes to criticize.

While we have struggled with this public-private compromise the past 15 years, most of the free world has implemented universal healthcare through their government. These countries are all achieving better health outcomes AND lower costs. This solution to meeting our human right obligation and lowering costs has been tested and proven multiple times across the world.

Universal healthcare does not mean the end of the private healthcare business. Many Americans have a lot of money.  They can still choose, on their own dime, luxury standards of service and prompter delivery. Healthcare providers that want to make a big profit will always have a market for such services.

We already see this in practice. If you have bad eyesight, you can get affordable glasses, or you can pay out-of-pocket for LASIK surgery. You can pay a big annual fee to sign up with a “concierge” primary care doctor and get an appointment whenever you want. You can pay for a luxury private suite in a hospital.

When I was 8 years old, I had a tonsillectomy at Cardinal Glennon Hospital. I spent a night in a room with seven other kids.  A private room would’ve been an expensive luxury.  My grandpa brought some quarters so we could watch “Gunsmoke” on a little black-and-white TV.

Maybe you think that was crappy healthcare, but it wasn’t so bad.  Even if my parents couldn’t pay, I had a right to be there.  And I’m certain it was a lot more affordable than how we do things today.