Sunday, May 15, 2011

Privilege or Right?

If there's one thing that everyone can agree on it's that healthcare is expensive. Unfortunately that's about all we can agree on. As I listened to the 2009 - 2010 health reform 'debate' and the many ripples that it spawned I kept coming back to the same question: Is healthcare a right or a privilege? This seems to be the real heart of the matter, at least for those not associated with an insurance or pharmaceutical company. That's really what we're debating isn't it?

On the liberal/progressive side are those who see this as a basic rights issue. They believe that access to medical care should be something all Americans can count on, no matter their financial status. On the conservative end of the spectrum it seems to be viewed as more of a luxury and that access should be something you must work for and earn. Now conservatives won't put it that way exactly, but that's really the unspoken truth behind all the careful prose. They want to sound like they care, but in the end they always seem to rely on going to the Emergency Room as the fallback position. As if that's some sort of cost cutting measure, which it most certainly is not. That just pushes the cost around, out of sight, till it's paid for by all of us in one shape or form.

I'm sure it's obvious where I stand in this debate. For me it comes down to a simple question of whether a person's lifespan and basic health should rest solely on the size of their paycheck. Is a subcontracting carpenter less worthy of a long, healthy life simply because his job doesn't afford him health insurance and he may or may not be able to afford a policy on his own? Is a network administrator's life more important because his job usually provides health insurance? And even if you remove the employer subsidized insurance from the equation, a net admin makes more than most carpenters, so he would be much more likely to be able to afford insurance on his own. Put it this way, the CEO of Goldman Sachs will never want for medical care, no matter what ailment he may suffer from. However a single mom working multiple part time jobs to make ends meet will have difficulty paying for treatment of a simple broken bone, much less something like cancer. So is the CEO more deserving of life than the single mom because he has a high paying job with top of the line health insurance?

We in America like to think we have the best medical care the world has to offer. And, in part, that may be true, based on how many of the world's great and powerful come here for treatment. But it's important to remember that medical care and health care are two completely different things. Medical care is the actual skill of the medical staff, the technology they wield and their ability to apply both to cure a condition or manage it for the best quality of life. Medical care is not concerned with cost, only results. Health care on the other hand is all about cost. Health care is exclusively focused on how much medical care you are allowed by your insurance and/or your personal finances. So America may indeed have stellar medical care, but that doesn't mean all Americans are in a position to actually benefit from it.

And that's where the rubber meets the road on this issue, isn't it? Stop blathering about 'death panels' and socialism. Strip away the histrionics, the hyperbole and the euphemisms and admit what this is really all about! Is a person's life only as valuable as his paycheck?

4 comments:

  1. That's a very shallow and maybe misleading characterization of healthcare in this country. Better questions would be: Why is healthcare in this country 1000% more expensive than it should be? Why are my tax dollars used to bail out UAW workers with their "Cadillac health plans", or used to give government employees better insurance than the rest of us can afford? If everyone retires at 65 and lives to 150 because of "the best healthcare in the world", who will pay for those 75 unfunded years of healthcare? If the president has his own personal physician on call 24 hours a day, shouldn't the rest of us also have this "basic human right"? Why is it that so many otherwise intelligent progressives (note omission of the 'S' word) can be so challenged with simple mathematics?

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  2. In response to Anonymous (above):

    There's nothing shallow or misleading about it, but it's a question many would prefer not to face. It's a valid distinction and the answer will completely change the landscape for discussion. In fact your 'what if' statement about living longer and who pays for it is directly tied to whether that care is an individual responsibility or a national responsibility.

    As to your other 'points', most would agree that the question about why health care is so expensive in the US as opposed to other countries is vital if any solution is to be found. But the blather about the President's access to 24hr care is just silly! There are a ton of real issues to debate on this, but it's pointless to confuse things with ridiculous non-examples.

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  3. In response to Erik...
    the point you make about the difference between health care and medical care is an important one. I imagine if there was no cost incurred by anyone but the patient, then all US citizens would be fine with everyone having medical care. It is only when people perceive that those who don't deserve care (for whatever one of a myriad of reasons) receive care, and that some of their pennies go to paying for that care, do people get a bit crazed.
    I don't agree that we have the finest health care in the world. I wish that was the case. It is good and I am grateful for it and my ability to utilize it but there are those who outshine us, especially in their view of who 'deserves' it.

    To anonymous...
    I am fairly confident should the time come when we live until 150, we will be well enough to work past 65 and in fact many places are beginning to adopt 70 as the retirement age. So maybe your energy would be better used on an issue that is at hand now.
    And I, for one, do not begrudge ANY US president an on call physician. In a time of crisis, should we perhaps get him to the ER or wait for the doc to arrive? Really? My life is as valuable as the president's but my presence in a national crisis is not. However, I still deserve access to quality health care, even if I have to stand in line for it or make an appointment.
    Not sure where you got that our health care costs 1000% more than it "should be". But I can tell you why...because there are people who stand to make money in providing it. We live in a capitalist society and when so much is 'for profit' and you don't have any other alternative (unless you consider suffering until death an option) then customers WILL land up paying more.

    There is nothing simple about the math involved in this labyrinth called healthcare. If you think that the uninsured aren't costing you money, then you are using the wrong calculations.

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