Cancer, Dignity, and Health Care

I've been featuring pieces by Pulitzer Prize winning journalist Gary Cohn over at the Mesothelioma Cancer Alliance Blog as they come out and he's got a new piece up about cancer and the Affordable Care Act.

The interesting notion in Cohn's discussion is the way he has framed the entire issue in terms of dignity. Note the contrast with the conservative opponents who always set out the issue in terms of purchasing a product. Their line is that the government should not tel us we have to buy a product, making health insurance equivalent to toothpaste. On this view, dignity is autonomy. A member of the marketplace is dignified if allowed to pursue his or her own enlightened self-interest without constraint.

Cohn's argument is that when you look at those who have pre-existing conditions, like cancer survivors, or who have long-term health care expenses that would exceed the lifetime limits in previously allowed plans, the way that the system as it was allowed to develop by the marketplace deprives those who are forced by bad luck of being treated in a dignified manner, that they are reduced to risks and figures on a spreadsheet to be minimized. Dignity is in being treated like a person, having your life and your projects respected as if they were one's own and that is exactly what the health insurance companies do not do, but which under the Affordable Care Act, they would be required to approach.

So, which notion of dignity ought to be in play here?