Right vs Responsibility
I hear these two terms being used a lot recently by politicians as they discuss health care for United States citizens.
One of the primary questions is whether access to health care is a right or a responsibility.
There has not always been fairly wide spread access to health care insurance or government programs such as Medicare and Medicaid. There has always been community support via way of church or other organizations. Sometimes this support is able to be very generous and sometimes it is much more limited.
When I was growing up, people in my parent’s income bracket only sought medical care (general medical or dental) if there was an emergency and possibly if a family member had a chronic medical condition or a condition such as pregnancy. It has not been that long ago that one could pay the general practitioner in food from one’s garden or in other home grown products such as chickens. If one did pay money then the fee was usually very low. Occasionally, even today, one will discover that medical persons are donating some of their time to free care and one might find that rare health care person who is willing to barter or see the person for what they can afford. Yet, most health care providers who are not getting paid a salary by some organization are unable to do that for more than a few hours a week or month.
Certainly, access to health care has never been equally distributed except perhaps in a small village environments. It is important that we begin to ask what has changed and now results in terms such as right and responsibility being used when discussing heath care. Actually, a great many things have changed including:
· Doctors, nurses and most other health care professionals no longer gained the “credentials’ by apprenticing themselves to a mentor. Years of extensive and expensive education is now required.
· The pharmaceutical industry has been birthed, refined and emerged as a profit making business for much of the world.
· The design, manufacture and sale of equipment from surgical tools to hospital beds and sophisticated machines such as the MRI has flourished and is also a huge profit making business.
· Modern communication and resultant changes in thinking have increased the number of people who are aware of the opportunities and disparities in health care choices and expectations for their family members.
· In the 1930s the health insurance industry was born and was eventually one of the bargaining chips for employers and/or unions.
· In recent years, the concept of portability of health insurance coverage was born or at least introduced as a possibility for wider group of people. This change coincided with the acceptance that few people were going to work for the same employer or their entire work life.
· More people gained the ability to travel and to immigrate to a country of their choice – legally and illegally.
· The concept of equality was fed, nurtured and grew with large number of people. The formal and informal concepts of caste, place, and even “God’s will be being increasing tossed aside along with sexism, homophobia or other forms of discrimination.
· The success of the systems feed the system. As more people live longer, more people require medical care. One sees that in all segments of the population but it is especially easy to observe and study with veterans, more of whom survive combat with every expensive care, mechanical devices and other services.
I am sure that I have neglected to mention some of the other chief factors which have brought us to this current discussion of who will or will not get health care coverage.
Within the context I am outlining, I now must ask what it means to be a responsible consumer. Apparently, the definition of responsible varies from person to person or political group to political group. The way it is currently being used seems to imply that, at the very least:
· Responsible people are able to get the job which provides good health insurance for an affordable price or are able to make the income to purchase health care insurance for themselves and their immediate family members including children age 26 or under.
· Responsible people do not have mental illness, addiction illnesses or other serious illnesses which prevent them from earning the income need to purchase quality health insurance.
· Responsible people at any early age have an acute understanding of the need for health insurance and are not limited by a youthful sense of immorality.
· Responsible people are not mentally challenged and they are still earning a very decent income.
· Responsible people are not farm workers, artists or others who earn very little money.
· Responsible people have heathy, loving partners or other family members who share in the cost of health insurance.
· Responsible people are not affected by racism, sexism, homophobia, ageism, or any other form of discrimination.
· Responsible people are not refugees or, if they are, they were wealthy in their home country and managed to take a lot of that wealth with them when they fled/left.
· Responsible people always are either abstinent until they are financially able to have a child or always practice fool proof birth control.
The word “right” as it is being used refers to the belief that all humans who are citizens of the United States deserve access to health care. Yet, even if one believes this, one still has to question if that is possible in a society in which major portions of the health care industry are for profit companies who expect to be paid very handsomely. By 8:00 a.m. this morning I had talked with:
· A man whose granddaughter has cancer in one eye and needs very expensive treatment which she will get at a famous facility in New York. The granddaughter is 7 months old.
· The mother of a teenager who recently had emergency surgery. When he got home he needed constant monitoring for two weeks.
· A friend whose young adult daughter needs long term residential treatment for addiction.
· A man who has various medical issues, some of which may be related to his serious addictive disorder.
· A young man who is living with a serious mental illness which often grossly distorts reality. He needs regular treatment with medication and psychotherapy.
One could list many more examples, but it is only just now 9:58 a.m. and I am just listing examples I have been appraised of so far today. Yet just thinking about the few examples I just listed, how are we to decide which of these individuals/families has a right to health care and which needs to be denied service? How do we decide who was “responsible” enough and who did not make the cut off?
I suspect that we need to quit using “easy” words such as responsible which are not helpful, to quit claiming we alone know the questions or the answers and attempt to approach health care within the context of all the related issues.
I further suspect that if we put aside all our preconceived notions and focus on problem solving versus ego building that we will begin to design a system which is multi-focused and begins to honestly answer some difficult questions. Without some drastic changes in our approach to this discussion we will continue to decide that increasingly large groups of people are not responsible and have no right to health care without having to openly take responsibility for the death of those who do not have a right to health care.
Written March 16, 2017
I hear these two terms being used a lot recently by politicians as they discuss health care for United States citizens.
One of the primary questions is whether access to health care is a right or a responsibility.
There has not always been fairly wide spread access to health care insurance or government programs such as Medicare and Medicaid. There has always been community support via way of church or other organizations. Sometimes this support is able to be very generous and sometimes it is much more limited.
When I was growing up, people in my parent’s income bracket only sought medical care (general medical or dental) if there was an emergency and possibly if a family member had a chronic medical condition or a condition such as pregnancy. It has not been that long ago that one could pay the general practitioner in food from one’s garden or in other home grown products such as chickens. If one did pay money then the fee was usually very low. Occasionally, even today, one will discover that medical persons are donating some of their time to free care and one might find that rare health care person who is willing to barter or see the person for what they can afford. Yet, most health care providers who are not getting paid a salary by some organization are unable to do that for more than a few hours a week or month.
Certainly, access to health care has never been equally distributed except perhaps in a small village environments. It is important that we begin to ask what has changed and now results in terms such as right and responsibility being used when discussing heath care. Actually, a great many things have changed including:
· Doctors, nurses and most other health care professionals no longer gained the “credentials’ by apprenticing themselves to a mentor. Years of extensive and expensive education is now required.
· The pharmaceutical industry has been birthed, refined and emerged as a profit making business for much of the world.
· The design, manufacture and sale of equipment from surgical tools to hospital beds and sophisticated machines such as the MRI has flourished and is also a huge profit making business.
· Modern communication and resultant changes in thinking have increased the number of people who are aware of the opportunities and disparities in health care choices and expectations for their family members.
· In the 1930s the health insurance industry was born and was eventually one of the bargaining chips for employers and/or unions.
· In recent years, the concept of portability of health insurance coverage was born or at least introduced as a possibility for wider group of people. This change coincided with the acceptance that few people were going to work for the same employer or their entire work life.
· More people gained the ability to travel and to immigrate to a country of their choice – legally and illegally.
· The concept of equality was fed, nurtured and grew with large number of people. The formal and informal concepts of caste, place, and even “God’s will be being increasing tossed aside along with sexism, homophobia or other forms of discrimination.
· The success of the systems feed the system. As more people live longer, more people require medical care. One sees that in all segments of the population but it is especially easy to observe and study with veterans, more of whom survive combat with every expensive care, mechanical devices and other services.
I am sure that I have neglected to mention some of the other chief factors which have brought us to this current discussion of who will or will not get health care coverage.
Within the context I am outlining, I now must ask what it means to be a responsible consumer. Apparently, the definition of responsible varies from person to person or political group to political group. The way it is currently being used seems to imply that, at the very least:
· Responsible people are able to get the job which provides good health insurance for an affordable price or are able to make the income to purchase health care insurance for themselves and their immediate family members including children age 26 or under.
· Responsible people do not have mental illness, addiction illnesses or other serious illnesses which prevent them from earning the income need to purchase quality health insurance.
· Responsible people at any early age have an acute understanding of the need for health insurance and are not limited by a youthful sense of immorality.
· Responsible people are not mentally challenged and they are still earning a very decent income.
· Responsible people are not farm workers, artists or others who earn very little money.
· Responsible people have heathy, loving partners or other family members who share in the cost of health insurance.
· Responsible people are not affected by racism, sexism, homophobia, ageism, or any other form of discrimination.
· Responsible people are not refugees or, if they are, they were wealthy in their home country and managed to take a lot of that wealth with them when they fled/left.
· Responsible people always are either abstinent until they are financially able to have a child or always practice fool proof birth control.
The word “right” as it is being used refers to the belief that all humans who are citizens of the United States deserve access to health care. Yet, even if one believes this, one still has to question if that is possible in a society in which major portions of the health care industry are for profit companies who expect to be paid very handsomely. By 8:00 a.m. this morning I had talked with:
· A man whose granddaughter has cancer in one eye and needs very expensive treatment which she will get at a famous facility in New York. The granddaughter is 7 months old.
· The mother of a teenager who recently had emergency surgery. When he got home he needed constant monitoring for two weeks.
· A friend whose young adult daughter needs long term residential treatment for addiction.
· A man who has various medical issues, some of which may be related to his serious addictive disorder.
· A young man who is living with a serious mental illness which often grossly distorts reality. He needs regular treatment with medication and psychotherapy.
One could list many more examples, but it is only just now 9:58 a.m. and I am just listing examples I have been appraised of so far today. Yet just thinking about the few examples I just listed, how are we to decide which of these individuals/families has a right to health care and which needs to be denied service? How do we decide who was “responsible” enough and who did not make the cut off?
I suspect that we need to quit using “easy” words such as responsible which are not helpful, to quit claiming we alone know the questions or the answers and attempt to approach health care within the context of all the related issues.
I further suspect that if we put aside all our preconceived notions and focus on problem solving versus ego building that we will begin to design a system which is multi-focused and begins to honestly answer some difficult questions. Without some drastic changes in our approach to this discussion we will continue to decide that increasingly large groups of people are not responsible and have no right to health care without having to openly take responsibility for the death of those who do not have a right to health care.
Written March 16, 2017
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