Curing the Ill – Should We?

There will always be the sick among us and it is a basic premise of ethical and religious systems that it is our responsibility to care for them and, where possible, to cure them. Even ignoring morality and focusing on self-interest, most people would be willing to expend the resources necessary to care for others in exchange for the guarantee that they will, themselves, receive such care when they are sick. It's likely, however, that they would express their support of the concept of caring for the ill in moral and ideological terms rather than self-interest.

While there have been, from time to time, some who would leave their sick and disabled on the side of the mountain to die, this has been viewed, by and large, as an aberration, and most civilized societies make health care a high priority. We see provision for the needs of those less able than ourselves as an obligation which is not lightly disregarded. In this country there is a sophisticated mix of medical and social programs which are addressed at these needs. In the medical field they involve private insurance, Medicare and Medicaid, “Obamacare,” as well as some institutions supported by governmental funds to provide service for those not otherwise covered. While it would not be accurate to suggest that the level of care is equal for all of our citizens and non-citizen residents (including undocumented aliens), the means exist for provision of some service for everyone.

That condition, however, does not always obtain. Situations can arise in which providers are forced to "ration" care by one system or another in order to function in a satisfactory manner. The paradigm of this situation is the triaging which takes place at the time of a disaster or a military engagement, when the number of individuals requiring attention is greater than can be handled by the system. At such a time a sorting of patients is made according to preset guidelines to determine who is in greatest need of attention or who is most likely to benefit from it. Those who do not meet these criteria would only be seen when, and if, resources later become available.

And there isn't unanimous opinion that tax money is the appropriate source for the costs of medical care – especially terminal care. Notwithstanding the moral strictures, they feel that people should pay for their own medical care, either directly or by the use of private insurance. Some acknowledge the inability of the poor to afford such care, yet many would deny them public funds to get it. They view such as charity, and maintain that charity is the responsibility of the individual, not the government.

It has, however, become a “given” that health care is a right. It's not explicitly in the Constitution, but our nation – indeed, many nations – consider it a state responsibility to ensure the health of all those living within their boundaries, whether or not they are citizens. It is decreed by medical ethicists and accepted by those on both the left and right (though with different degrees of enthusiasm) that some form of guaranteed care be available to all. The Republican Party assures us all that they'll repeal Obamacare and replace it with a “better” version of health insurance. Even they agree that some plan is necessary. (I don't know if, by the time this is published, changes will have been made.)

But is it? Would the knowledge that each of us is responsible for his own health care, and the government won't pick up the tab for those on welfare, help to encourage some of those who aren't doing so already to seek employment? Similarly they reject care for those here illegally. And those who are interested in the most efficacious use of health care dollars and other resources may consider it reasonable to deny care to those either deemed “unfit” or unsalvageable.” Another group that might approve are those who (secretly) might want to “pull the plug” on suffering family members, but would feel guilty if forced to make the decision themselves. I personally don't subscribe to all of those ideas, but we're burying our heads if we don't recognize that they exist.

I won't be subtle or deceptive. I want to be sure that, when the time comes, I receive the best available care. I've been paying for it and I want it. Ideally it should come from my own funds and insurance, or be provided by charity. However I don't trust my fellow man to care about anyone but himself, so, if the “crunch” should ever come, I'd rather rely on the government. Not that I trust the government and politicians. I don't. But I know that the prime goal of politicians is to be elected, so they'll do everything they can to guarantee the safety and health of their constituents. They care about themselves, so they care about me and every other voter. They're sure to vote for health care – especially since the voters will wind up paying for it.

It's not a matter of curing the ill. But they want to be elected and I want to be cured. Whether my life is worth anything to others – whether the use of medical resources on me would be justified in their eyes – I agree that it is society's obligation to care for the ill. Especially me.

March 5, 2017