Ideology versus Ethicality in the Enactment of Obamacare: Justice and Autonomy as Contested Issues

Main Article Content

Oussama Mahboub

Abstract

One of the most politically debatable issues in America is the reform of the healthcare sector. The heated dispute is conducted by liberals and conservatives. Accordingly, among the programs that helped divide the American ideological spectrums was the enactment and implementation of the Patient Protection and Affordable Care Act (ACA, Obamacare) in 2010. The law received unconditional acclaim by liberals and severe criticism from conservatives. The present paper attempts at analyzing both the impetus that lies behind the political division over the law and the conformity of the two ideological spectrums with major public health ethical principles including justice and the respect for persons' autonomy. Through taking Obamacare as a case study, this research uses the Metaphor Theory adopted by George Lakoff in order to trace the endeavor behind the liberal and conservative policies, and employs two key contested principles included in a relevant theory known as Principlism, namely justice and autonomy in an attempt to assess the extent of the liberals' and conservatives' compatibility with public health ethics. This study sums upwith the idea that the liberal moralists show more conformity to public health ethics highlighted by the justice and autonomy principles compared to their conservative counterparts.


 

Article Details

How to Cite
Mahboub, O. (2021). Ideology versus Ethicality in the Enactment of Obamacare: Justice and Autonomy as Contested Issues. Milev Journal of Research and Studies, 7(1), 387–404. https://doi.org/10.58205/mjrs.v7i1.723
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References

Austin, A. (2015). Obamacare Reduces Racial Disparities in Health Coverage. Consultedon 01/03/2021, from Center for Global Policy Solutions: http://globalpolicysolutions.org/resources/obamacare-reduces-racial-disparities-in-health-coverage/

Beauchamp, T. L., & Childress, J. F. (1979). Principles of Biomedical Ethics. New York: Oxford University Press.

Boston University School of Public Health. (n.d.). Raising Money and Paying Caregivers. Retrieved 01/05/2021, from https://sphweb.bumc.bu.edu/otlt/mph-modules/hpm/americanhealthcare_paying/PM702_Paying_print.html

Center on Budget and Policy Priorities. (2019). Chart Book: Accomplishments of Affordable Care Act. Consulted on 01/02/2021, from https://www.cbpp.org/research/health/chart-book-accomplishments-of-affordable-care-act

Crisp, R. (2004). Aristotle: Nicomachean Ethics. Cambridge: Cambridge University Press.

Daniels, N. (1996). Justice and Justification: Reflective Equilibrium in Theory and Practice. Cambridge: Cambridge University Press.

Daniels, N. (2008). Just Health: Meeting Health Needs Fairly. New York: Cambridge University Press.

Dickman, R. L. (1983). Operationalizing Respect for Persons: A Qualitative Aspect of the Right to Health care. In A. C. R. Bayer, In Search of Equity: Health Needs and the Health Care System (pp. 161-182). New York: The Hasting Center.

Faguet, G. (2013). The Affordable Care Act: a Missed Opportunity, a Better Way Forward. New York: Algora Pub.

Höffe, O. (2010). Kant’s Innate Right as a Rational Criterion for Human Rights. In L. Denis, Kant's Metaphysics of Morals: A Critical Guide (pp. 71-92). New York: Cambridge University Press.

Jost, T. S. (2012). The Affordable Care Act Largely Survives The Supreme Court’s Scrutiny—But Barely. Health Affairs, 1659-1662.

Lakoff, G. (1995). Metaphor, Morality, and Politics, or, Why Conservatives Have Left Liberals in the Dust. Social Research, 177-213.

Lakoff, G. (2016). Moral Politics: How Liberals and Conservatives Think. Chicago: University of Chicago.

Lakoff, G. a. (2012). The Little Blue Book: The Essential Guide to Thinking and Talking Democratic. New York: Free Press.

Mahboub, O. (2020). Political Debate Over the Reform of the American Health Care System: The Case of "Obamacare". Revue de Traduction et Langues, 40-55.

Mill, J. S. (1906). Utilitarianism.Chicago: The University of Chicago Press.

Mill, J. S. (2001). On Liberty. Kitchener: Batoche Books.

Monaghan, M. (2013). The Affordable Care Act and Implications For Young Adult Health. Translational Behavioral Medicine, 1-5.

Nagel, T. (1989). Rawls on Justice. In N. Daniels, Reading Rawls: Critical Studies On Rawls' A Theory of Justice (pp. 1-15). New York: Stanford University Press.

Ortmann, L. W. et al. (2016). Public Health Ethics: Global Cases, Practice, and Context. In L. W. Drue H. Barrett, Public Health Ethics: Cases Spaning the Globe (pp. 3-36). Switzerland: Springer Open.

Pianin, E. (2015). Obamacare Falls Short on Sign-Ups While Co-Op System Crumbles. Consultedon 01/04/2021, from The Fiscal Times: https://www.thefiscaltimes.com/2015/10/18/Obamacare-Falls-Short-Sign-Ups-While-Co-Op-System-Crumbles

Rawls, J. (1985). Justice as Fairness: Political Not Metaphysical. Philosophy & Public Affairs, 223-251.

Rawls, J. (2009). A Theory of Justice. Massachusetts: Harvard University Press.

Ross, D. (2002). The Right and the Good. Oxford: Oxford University Press.

Sullivan, S. (2013). Ben Carson: Obamacare Worst Thing ‘Since Slavery’,. Consultedon 02/02/2019, from The Washington Post: https://www.washingtonpost.com/news/post-politics/wp/2013/10/11/ben-carson-obamacare-worst-thing-since-slavery/

Taylor, J. S. (2012). The Carelessness of Affordable Care. Hastings Center Report, 24-27.

United Nations. (s.d.). The UN Convention on the Rights of the Child. Consultedon07/03/2019, from https://downloads.unicef.org.uk/wp-content/uploads/2010/05/UNCRC_summary-1.pdf?_ga=2.91582236.726100458.1562147939-1245682481.1562147939

Wisconsin Budget Project. (2016). Six Significant Achievements of the Affordable Care Act. Consultedon 01/02/2021, from http://www.wisconsinbudgetproject.org/six-significant-achievements-of-the-affordable-care-act

World Health Organization. (2006). The Constitution of the World Health Organization. Consultedon31/10/2020, from http://www.who.int/governance/eb/who_constitution_en.pdf