Health Care is a Right and We All Deserve It.
In spite of what Paul Ryan said they are still twisting arms to get the votes for their version of health care. Donald Trump’s recent remark “Nobody knew health care could be so complicated” could be considered farcical by some, perhaps even a half-hearted attempt at comic relief. Most of us who reside in the U.S. at some point in our lives face the issue of dealing with our own health care issues and even with the best coverage provided via the workplace we recognize the complexity of understanding the language and details of choosing a plan that accommodates our needs. Although the economics and architecture of a health care delivery system may be the focus of legislators and administrators there are underlying social and cultural attitudes about health care which suggest a deeper and more personal complexity. How we define ourselves as individuals, our sense of self worth and place in the world is fundamental to the discussion of human needs.
Our views are conditioned by spiritual and philosophical influences as much as by economics. For some the belief that God will provide is the determining factor in addressing responsibility and support for our own frailties. That view may be a further proscription dependent upon how “worthy” we may be considered in the eyes of our spiritual mentors and institutions. The notion that suffering defines and prepares us for greater trials and holds the promise of redemption is a powerful concept which tempers some people’s views on how we should care for each other. It is in part this “Calvinist” strain which provides a sub-text in the discussion of health care.
The idea of denial as a virtue is a powerful inhibition in shaping a public health policy. How we describe what basic health care should consist of let alone it’s cost is also subject to a more venal pragmatism which passes judgment on an individuals worth based upon their financial state. Although the charitable attitude towards “the poor” has served as a guide towards our approach to developing a posture and response to community needs the corollary of personal responsibility has also served as a cautionary against providing services to the “less deserving’. These spiritual and cultural prohibitions may not have an overt or recognized role in developing a secular and public policy yet they cannot be dismissed out of hand.
It may be true that we are organisms subject to the laws of nature, that we are essentially living in a petri dish. Disease is no respecter of our social or spiritual affiliations and any policy dealing with the health and welfare of the community should have as it’s paramount concern this elemental consideration. The success and efficacy of any public health policy is to a great extent dependent upon how we address and manage such inclinations towards constraint which may place the larger community at risk The Emergency Medical and Treatment Labor Act passed by Congress in 1986 allows that despite one’s financial status they cannot be denied proper medical care in an emergency. This is essentially an affirmation that health care is a “right”. It is limited in it’s context and specific in it’s remedy yet it does not allow for option nor qualify it as a privilege.
For those who embrace the concept that health care is a human right the challenge is in translating how that is implemented in a practical and meaningful way. Although it makes more sense to discuss the subject in an exclusive manner employing scientific, clinical and empirical experience as determinant criteria we cannot seem to escape the folk like ethos of a large swath of people whose lives have been shaped by scarcity and admonition. If there ever truly was an era of rugged individualism then the successive generations brought up to value the prerogatives of the individual over the benefit to the community at large continue to play a role in how health care has been perceived in our Country. How else could the issue of mandatory participation in supporting a public health care plan be so exploited for political expediency? Perhaps the most despised aspect of the Affordable Care Act was the mandate of participation, having to demonstrate personal responsibility for one’s own health care.
Those who decry such a policy insist that it is their right to refuse paying for but not receiving care. After all the E-Room has been the choice for so many all these years and the only insurance premium many want or can afford is catastrophic coverage. The problem is that for every patient relying upon the emergency services at a hospital or clinic those costs are transferred to those of us who have insurance. Why is it that for some the idea of preventive measures, vaccinations, wellness checks seem like unnecessary benefits yet they have no problem demanding care when they get sick or injured? There is still a contagion of self denial wrapped up in pride which binds people to a romanticized view of character and conflates that with behavior. To ask for help or suggest that one deserves consideration is to demonstrate weakness of the spirit and weakness of one’s constitution.
It reminds me of the verses from Leonard Cohen’s “Bird on a Wire”: “I saw a beggar leaning on his wooden crutch,he said to me, “You must not ask for so much.”And a pretty woman leaning in her darkened door,she cried to me, “Hey, why not ask for more?” It is this very contradiction in America today which further complicates the controversies surrounding health care. Our freedoms are great and manifold but when it comes to dealing with how we care for ourselves and others we are faced with some hard choices which for some may mean a compromise of their freedoms. Does anyone have a right to carry an infectious disease about and pose a threat to others health? Are we responsible for the well being and health of our children, elderly and indigent? These questions are elemental in addressing the larger issue of public health and everyone should be prepared to discuss and answer them if we have any hope of moving forward towards a comprehensive and just solution.