January 21, 2013 Liz Borkowski, MPH 1Comment

This is the part of President Obama’s 2013 inaugural address that resonated with me the most:

We, the people, still believe that every citizen deserves a basic measure of security and dignity. We must make the hard choices to reduce the cost of health care and the size of our deficit. But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.

For we remember the lessons of our past, when twilight years were spent in poverty, and parents of a child with a disability had nowhere to turn. We do not believe that in this country, freedom is reserved for the lucky, or happiness for the few. We recognize that no matter how responsibly we live our lives, any one of us, at any time, may face a job loss, or a sudden illness, or a home swept away in a terrible storm. The commitments we make to each other – through Medicare, and Medicaid, and Social Security – these things do not sap our initiative; they strengthen us. They do not make us a nation of takers; they free us to take the risks that make this country great.

As I’ve written before, there are both practical and moral arguments for our country’s social safety net, which includes Medicare, Medicaid, Social Security, and other programs. Obama alludes to the practical argument with his reminder that risk-taking is one of the things that makes this country great. Having a strong safety net makes it easier for people to take worthwhile risks, from launching a new business to going on strike to protest injustice.

The moral argument is that we don’t want anyone to be doomed by a single setback, whether it’s job loss, disease, disability, or a hurricane. Obama stresses that these things can happen no matter how responsibly we live, and that’s an important reminder. At the same time, many of us (particularly in the field of public health) think we should work toward good health for all, even if some of the people who benefit from government programs have made poor choices or taken foolish risks.

The Affordable Care Act was the signature ahcievement of President Obama’s first term. It wasn’t the healthcare reform law many of us hoped for, but it’s a major improvement over the 2009 status quo. And at its core is the same idea that Obama alluded to in his remarks today. Affordable, high-quality health insurance shouldn’t just be for those fortunate to get it through large employers or government programs like Medicare. We want it to be within the reach of everyone, including those who’ve been laid off or have pre-existing conditions.

“The commitments we make to each other – through Medicare, and Medicaid, and Social Security – these things do not sap our initiative; they strengthen us.” These words are a fitting start to President Obama’s second term. I hope in the next four years we’ll see a strengthening of these programs that strengthen our nation.


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