For most of my adult life, I believed that healthcare was a right and that it was the job of the federal government as the representative of the people to administer that right. Now I am not so sure. Perhaps it has something to do with the State of North Carolina’s bankrupting the State Health Plan and then shirking a creative solution; opting instead to first raise employee costs, and then, eventually to push workers off the State’s rolls and onto the federal government’s doorstep (1). Maybe it’s about a dislike of one-size fits all healthcare and the straight truth that most politicians aren’t trained as doctors and shouldn’t be in the business of making medical decisions. Maybe it’s because I don’t trust our politicians to be in it for the American people when dealing with the insurance companies’ lobbyists. Perhaps I am increasingly more willing to cast my lot in micro-lending fashion with other private citizens. In any case, my viewpoint is decidedly murkier than it was only a few years ago.
I am certain though of a few things. These are not answers. Definitely not solutions. But I’d very much like to re-start the healthcare debate with these ideas in mind. In many respects it feels like we missed a turn somewhere back there many decades ago and ended up ignoring the big picture questions, so that now we’re lost in a dark woods of details without an agreed upon map to guide.
So let’s start at what I consider the beginning. First, we must ask: “Is healthcare a right?” The United Nation’s Universal Declaration of Human Rights says, “Yes.” Article 25 reads:
“(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection” (2).
Okay, great. Totally agreed on this. Humans should care for humans; and we should take special care to safe guard our species’ existence by giving the best we have to give to pregnant women, nursing women and children.
But what happens when, for example, there isn’t enough flu vaccine for every child? The bottom line is that healthcare is a resource and resources have to be allocated. Eventually we have to come up against the fact that we can’t give every citizen of the United States, or every citizen of the world, the same level of healthcare. There simply isn’t enough to go around – particularly when you are talking about traditional Western medicine, heavy on expensive diagnostics, specialized equipment and pills for everything that ails you and some. Can we make something a right that we have no means of equitably fulfilling? I don’t know, feels squirmy to me.
I’d much rather see us start the healthcare issue off with a universal intention. In magic, we learn that everything flows from intention. It’s also how I approach art, setting my intention in the abstract world of force, of all possibility, rather than in the problematic world of forms. Intention is planning without the need to decide specifics. Intention sets the outer boundaries and focuses energies. Intention can pull you through the dark woods when you’ve gotten lost.
What would it be like if universal healthcare wasn’t a right, but a human intention? Something like this: “It is our intention as humans to care for each individual member of our species to the best of our ability.”
Yes, we will still need to grapple with resource constraints, but I definitely feel differently when I am defending a right versus supporting an intention. With a universal healthcare intention I know that it isn’t about fighting for my individual share of limited resources, but rather about knowing that my community will always strive to do the best they can for me – balanced with the needs of everyone else living in that community and the reality of the resources with which we have to work.
After we are able to agree on an intention, then we can start to worry about the details. And I suggest we start once again by examining how we’re coming at this problem. We need to take a serious look at what constitutes “giving care to the best of our ability.” In attempting to answer this question, I’d strongly suggest we hear from the people who currently work in our health care industries – those on the front lines – EMTs, nurses and doctors.
In an article titled How Doctors Die, It’s Not Like the Rest of Us, But It Should Be, written for Zocalo Public Square, Dr. Ken Murray offers insight into the perspective doctors might bring to bear in answering my question. “What’s unusual about [how doctors die] is not how much treatment they get compared to most Americans, but how little,” he writes (3).
The article goes on to explain that healthcare professionals know first-hand what it means to “take heroic measures.” They understand that CPR, when performed correctly, will break ribs. Murray then discusses what he calls “futile care” and describes it as follows: “That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist.”
Murray then asks a key question: “How has it come to this — that doctors administer so much care that they wouldn’t want for themselves?” Now that is a great question. He concludes by deciding that both patients and doctors are to blame, but that both parties are working within the context “of a larger system that encourages excessive treatment.”
Sometimes it’s important not to look to the system to solve the system’s problems, but to look beyond the system for something new. Sometimes the system is its own problem.
Okay, so where does this leave us?
Whether we decide healthcare is a right or a societal intention, we must grapple with the fact that it’s a resource and must be allocated. If we are going to approach a system that’s fair and able to offer each of us a high level of care, we are going to have to let go of a few things. We are going to have to admit that doctors aren’t God; that we all die; and that a medically prolonged life may not be “giving care to the best of our ability.”
And perhaps most importantly, as a society we are going to have to embrace prevention. Starting with the most basic – what we eat.
© Jennifer S. and harvestliberty.net, 2012.