American foreign policy had built such programs abroad since the Marshall Plan, so why not at home?
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Millions of lives are prolonged or saved throughout the world, thanks to United States-supported health programs. But Americans aren't so lucky. For many, the best way to get affordable treatment at U.S. taxpayers' expense might be to move to a poor country that is committed to building universal coverage, backed by U.S. development aid.
The Supreme Court decision on the Affordable Care Act opens the possibility that the United States may now begin to domestically implement policies that foreign aid agencies and the Department of Defense have long supported, both politically and economically, as elements of U.S. foreign policy. It may now be possible to harmonize longstanding U.S. foreign and domestic policies regarding healthcare access for poor and middle class peoples.
Dating back to the Marshall Plan in post-WWII Europe, General Douglas MacArthur's 1945-1949 occupation of Japan, and then the Korean War, it has been a matter of U.S. foreign policy to invest in the creation of universal health systems. More recently, the Marshall Plan was cited by AFRICOM in support of a Department of Defense engagement in health systems construction across Africa. This year, South Africa was the number one recipient of health aid from the United States, totaling nearly $470 million, much of which is supporting the country's 14-year program to build universal health coverage.