This is the ninth and final entry in a series that has examined how seven people who live in the town of Helena-West Helena, Arkansas, would fare under the health proposals offered by John McCain and Barack Obama. The entire series is archived here.

The policy wonks have begun their hand-wringing. “If the country’s finances get too depleted, both parties could lose their zeal to retool the health care system,” John Holahan, director of health policy for the Urban Institute, told the Des Moines Register. In a Chicago Tribune op-ed last Sunday, noted bioethicist Ezekiel Emanuel conceded that “the financial crisis has appeared to knock health care off the national agenda,” while arguing that the crisis might make reform more politically feasible, and even necessary for financial stability. A few weeks ago on NBC’s Today, Barack Obama said that the financial bailout means that he cannot immediately accomplish everything that he has proposed during the campaign: “I think we’re going to have to phase it in. And a lot of it’s going to depend on what our tax revenues look like.”

Okay, so the county’s financial problems might have deflated the momentum that was building earlier for health care reform. Apparently, the government doesn’t have money to help both the big, bad businesses that got into trouble and the little people who can’t pay for health insurance. In other words, the billions needed for subsidies to help people buy private health insurance have been put to other uses. There are also stirrings that maybe we shouldn’t be helping people who don’t have insurance anyway. The reasoning goes like this: It’s their own fault if they smoked and got cancer or ate too much and got diabetes. For awhile, it looked like the country was beginning to agree that everyone is entitled to health care. Even the American Medical Association and the insurance industry have even come around to that idea. In last week’s debate, Barack Obama affirmed that health care is a right; John McCain did not, saying instead that health care was a responsibility. Whose responsibility, he didn’t quite make clear.

Now along comes Robert Samuelson, columnist at The Washington Post and contributing editor at Newsweek, challenging the notion of health care as a right. Samuelson argues that casting medical care as a simple right ignores questions of how far that right should extend, and how its fulfillment might compromise other rights and needs. He contends that personal habits, genetic makeup, and age make people healthy or unhealthy, and adds:

The crying need now is not to insure all the uninsured. This would be expensive {an additional $123 billion a year, estimates the Kaiser (Kaiser Family Foundation) study} and would provide modest health gains at best. Two-fifths of the uninsured are young (19 to 34) and relatively healthy.

As I read Samuelson’s piece, I thought of the people whose stories we have told on the Campaign Desk. Which ones don’t have a right to have health care? Who is more deserving of medical treatment? The 43-year-old with symptoms of uncontrolled diabetes because he can’t pay for care? The disabled woman whose $758 monthly income from Social Security disability is too high to qualify for Arkansas Medicaid? The farmer who has no coverage for his urinary problems? The insurance agent’s son who suffered a concussion playing football?

Superficial describes this year’s health care discussion. There has been a lot of talk about getting insurance into everyone’s hands, but little conversation about equity and poverty. In fact, it seems the candidates have aimed their health care comments toward the middle class. Except for a few “blame-the-victim comments” like Samuelson’s, there hasn’t been much said about the larger causes of poor health: like stress from being unable to pay your bills, or jobs affording little down time, or bad housing, or the chemicals sprayed on cotton. Almost everyone I interviewed in Arkansas—black or white, rich or poor—at one time or another in their lives picked cotton. “Health Care on the Mississippi” indicates a universal need for medical treatment. But despite the campaign rhetoric, the candidates’ proposals will get us neither universal care nor universal insurance to pay for it.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.