Politicians should be sued for malpractice when it comes to resolving health care issues in America
The question of access to, and the scope of, health care in America has been a long-term, intractable dispute. At the core of the debate, contributing to the elusiveness of a solution are two, sometimes contradictory, philosophies. One is the long-term American societal acceptance of the Judeo-Christian belief in the “sanctity of life.” This philosophy mandates that a paramount duty of society and its government is to do everything that can be done to protect, preserve and extend life. (This is why the question of “when life begins” is such a critical issue in the “right to choose” versus the “right to life” debate.) Also in the mix of the health care brouhaha are the traditional American concepts (myths) of “rugged individualism,” self-reliance, freedom of choice, free markets, and fear of the incursion of government into the private lives of individuals.
All these elements have been intermingled to produce a caldron filled with emotional, passionate, confusing, sometimes deceptive debate over the form and scope of access to health care in America, and that has frustrated practically everyone. The only group that seems satisfied with the current state of health care in America is the health insurance industry that remains free to “cherry-pick” from among the masses selecting not only who can receive coverage, but what type is received and at what price. As a result, health care is rationed and almost 50 million American citizens are left with no health care coverage – even if they can afford it – and millions more have only limited benefits.
Curing the ills of the health care system in America will never be accomplished unless the superficiality of these emotional terms is overcome and the debate is reduced to a simple question: Is access to basic health care for all American citizens a “right” or a “privilege?” Only when this hotly debated question is resolved will a clear path emerge to determine the future structure and form of health care in America.
Better Late than Never
Most major industrial countries have already answered this question and have overwhelmingly concluded that basic health care is a “right” not a “privilege.” In fact, the United States is the only country of the top 46 industrialized nations not to view basic health care as a right. And it’s highly unlikely that the citizens of the U.S., as opposed to its leaders, believe in such an isolationist view.
To find out, ask yourself this question: As an American citizen who is guaranteed the right to “life, liberty and the pursuit of happiness” by the Declaration of Independence, do you believe that includes the “right” to receive basic health care to protect, preserve and extend your life? Or do you believe that the guarantee of “life” applies only so long as you (and your family) don’t get sick? Do you honestly believe that your “right to life” stops at the front door of a hospital and that basic health care is really a “privilege” that should only be available to those who can find and afford it?
When you cast the health care issue in any other way, the debate creates a number of incongruities. For example, many thinking adults earnestly resist the idea that basic health care is a right that should be guaranteed by the government. They shudder at the thought of government incursion into something as personal as their health. They also fear the loss of freedom to choose who provides the care and what type of treatment. Yet, for some reason these same people seem to believe that a private insurance company – one that can reject, cancel or limit their care and charge the premiums they decide, all in the name of making greater profits — will, for some altruistic reason, care more about them than the government. It is also telling that many people who passionately argue that any unborn child has a “right to life,” and yet are, paradoxically, unwilling to guarantee that this same child has a “right” to health care once they are born.
It is my belief that if Americans are presented with this clear choice between health care being a “right” or a “privilege,” the vast majority would come down on the side of what is right. Just as basic education has been considered a right for every child, even for the poorest child from a broken home, since the 1850s. Just as every American believes they have a right to personal safety and security from police and fire protection. What American was not raised with the belief that they have a right to “life, liberty and the pursuit of happiness?” If we have a right to “life,” would that not include health care to protect and extend that right? If we look to government to protect our life and preserve our liberty, why should the government not be charged with assuring (although not necessarily providing) that every American citizen has access to basic health care?
If you sincerely believe that finding, securing and receiving basic health care is not a right, but is rather the responsibility of the individual, then you will be satisfied with the existing system of “privilege,” because that is how it works. However, if you are one who believes the “right to life” includes the right to have that life protected, preserved and extended, you will recognize the need for a different approach to structure and accessibility of health care.
If we can agree that access to basic health care is a right and not a privilege, then finding a solution to provide and protect that right, while respecting the individual’s desire for freedom of choice, is actually quite simple. Probably the closest parallel for this is the system of public education. Every child born in America is entitled to a publicly-funded education, paid for by local, state and federal taxes or grants. Through high school there are no fees to the child, but if they want to go further – on to public college –then a series of co-pays come into play.
All during this process the family has the privilege – if they have the desire and resources – to seek alternatives to the public system. They are free to send their children to private schools, retain tutors, or home-school their offspring, just so long as they could afford it and meet the minimum standards of a public education. If the student is not using the public system, sometimes vouchers are even offered to help offset the cost of private education. This system has provided the “right” to a basic education, while maintaining the “privilege” for the individual to go beyond that system, so long as they had the resources to do so.
Providing the right to basic health care could follow a similar approach. The existing Medicare system (with Medicaid folded in) could be expanded to provide basic health care for all citizens from “cradle to grave.” These services could be provided by expanding the existing Medicare payroll and employer taxes. (Employer expenditures would be reduced because there would be no need to provide employee group health care benefits.) Cost of the program could be reduced by implementing a “needs based” system of increasing co-pays for services provided, based upon the income or the net worth of the individual covered.
All during this process the individual would have the privilege – if they have the desire and the resources – to seek alternatives to the public health care system. They could purchase private insurance that would cover co-pays. They could seek additional services or specialist care that go far beyond those provided by the basic program. Those who decline to participate in the public program could be issued vouchers for the purchase of private insurance plans; just so long as they met the minimum requirements of the public plan.
This outline of a reformed health care system that would offer access as a “right” for all American citizens is too brief to be perfect. It raises more questions than it answers, but the objective here is simply to suggest that if, as a society, we decide that basic health care is a right and not a privilege, then resources can be shifted from focusing on the problem to finding a solution.
And the moral of the story …
The question of access to and the scope of health care in America has created a cornucopia of confusion, consternation and conflict, all because of the failure to ask the most basic question: Should health care for all American citizens be a “right” or a “privilege?” The problem is that special interests, moneyed powers and weak, self-serving political leaders have a vested interest in not focusing on the simple issue to be resolved. Unless and until that happens, a simple problem will continue to be complicated. This is not right and we have a right to demand a change.