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
