Is Healthcare a Right or a Privilege?

The health care system in our country is broken.  I don't think anyone can dispute that.  If you don't think there's a problem, just go read Kyla's eloquent post about her family's struggle to keep health insurance.  I dare you.

There are 46 million uninsured people in the United States, the richest country on earth, including almost 9 million children.  Often, those who are uninsured must choose between financial ruin or getting the health care they and their children need.  That's unconscionable.  How do we fix it?

I don't pretend to be an expert here.  There are arguments for and against everything and studies supporting and opposing everything.  I'm trying to look at the health care issue with common sense.  The obvious answer to me, and many Democrats, is universal health care.  We need some system, or combination of systems that will permit those who are uninsured to get the coverage they need. 

There are plenty of nay sayers and we'll be hearing from lots of them during the upcoming election.  There are those who insist they will never vote for a President who advocates universal health coverage.  Let's look at their basic arguments:

1. Our country can't afford to pay for everyone's health care.

I can't break down the numbers for you.  Wiser people than me have done it a million times over.  But there are a few things we need to keep in mind.  Reforms in our system to bring down health care costs will have to made anyway.  Even our system of private insurers cannot keep up with the rate of cost increases.  Insurance companies pass their costs on to the insureds.  Those with private insurance pay more and more until they can't pay any more.  Those with group insurance face the same situation. 

If our goal is to reform the system to the point where it is sustainable, why not reform it to the point where it is sustainable for everyone?  Of course, what can actually be done and what we can actually pay for is up for debate, with studies on both sides. Wikipedia, of all places, has a nice summary of the studies on both sides.

However, having uninsured people increases the costs of our care even now.  If you can't afford to seek preventative care for your congenital heart condition, you may leave it until you have serious complications and then go to the emergency room.  It is illegal to deny emergency care and a chronic condition that could have been maintained with regular care, medication and treatment is now a life threatening and very expensive condition.

This is a never ending cycle.  As costs increase, more people will become uninsured, increasing costs even more.  If you look at it this way, we can't afford not to insure everyone.

2. The private sector can be more efficient than any government agency.

Having worked for the Department of the Army, I understand where people are coming from with this argument.  But none of the candidates are currently proposing a single payer health system.  Both HRC and Obama have proposed variations of a system where private insurers would still compete for our business and those who are not insurable or can't afford insurance would be covered by a government plan similar to Medicaid.

Again, reforms will have to be made both in the insurance industry and in the health care industry.  I've worked both for the federal government and a private health insurance company with a certain famous TV show named after it. I can tell you that waste and bureaucracy is not limited to our government.  There's plenty of work to be done in both sectors.

3. People should take personal responsibility for the costs of their own insurance and health care.

Personal responsibility is a wonderful thing but there are also certain responsibilities that we have as a society.  One of those is to help our fellow man.  There are millions of people out there who simply cannot be insured.  Go read Kyla's post again.  Weren't you paying attention?  Plenty of hardworking, tax paying, God faring, and even conservative leaning people out there simply don't have insurance available to them or they cannot pay for it.

You can buy a DVD player for less than the cost of many prescription medications.  Seriously.  I just bought a DVD player at Target for $29.  My monthly car payment is less than the cost of my last high risk pregnancy ultrasound.  My yearly mortgage on my nice big house is more than the cost of my last hospital stay.  So what happens when you or one of your children is hit by a car while crossing the street, requiring a 10 day hospital stay, multiple surgeries, and months of rehabilitation?  Hell, there are small cities out there that couldn't afford that.

When my son had a one week hospital stay when he was 4 months old, I didn't pay for it.  I paid a $100 hospital stay co-pay.  That's it.  When I racked up more than $150,000 in health care costs in two high risk pregnancies, I didn't pay for that either.  I definitely paid more than $100 in co-pays, but I'll estimate and say that I only paid roughly 10% of that 150K.

I didn't pay for it.  This isn't about my personal responsibility.  My employer  and my husband's employer paid for the insurance that made such low costs possible for us.  We have fan-f*cking-tastic insurance that we only pay about $400 a month for.  We both have great jobs with wonderful benefits.  We both have advanced degrees and the experience to ask for and receive such benefits.

Can everyone be like us?  Hell no.  It would be ridiculous to suggest that.  No amount of "personal responsibility" will make everyone a lawyer or a doctor or a government employee or a fire fighter or a teacher or a member of Congress.  Those jobs all tend to come with nice benefits.  But many people work hard for small businesses that can't afford to pay their employees' health insurance.  Or they work for minimum wage and, after taking out the cost of housing and food, they still can't afford to pay the monthly premiums on their employer's plan.  Or, like Kyla, they find themselves in an untenable situation where they make too much money to qualify for public programs like SCHIP but too little to pay the costs of the care their children require.  Or they aren't insurable at all.

Hell, after reading Kyla's story, my husband (the Republican) finally came to the realization that if neither of us had group insurance available to us, we'd be screwed.  You see, I'm a diabetic and pretty much uninsurable.  Or any insurance I could obtain wouldn't actually cover any of the preventative care and medications I need on a regular basis.  We could probably pay for them now on our own, but what if my condition worsens and my eyesight is threatened?  What if I need an amputation or a hospitalization?

If you don't have insurance or, if you're one of the countless millions more who are under-insured, what do you do?  You lose your savings, maybe your home, and you may have to declare bankruptcy.  Have you checked your insurance policy lately?  Do you have any idea what your policy limitations are?  Do you know how much you could be on the hook for with a $175,000 hospital stay?  Maybe you'd better check again.  We wouldn't want you to shirk your personal responsibilities.

4. I don't want my quality of health care to decrease or my health care to be rationed.

This is what it really comes down to, isn't it?  We don't want our lives or our pocketbooks affected by someone else's health care.  We don't want to pay for someone else's care although, trust me, you're already paying for it indirectly.  We don't want to have to wait longer to see a specialist or have shorter visits or be wheeled out into the street with an open surgical wound.

I get that.  I do.  From personal experience, I know how incredibly frustrating it can be when you can't get your child the care he needs right now. Do I buy the argument that we'll all be stuck waiting for 5 years in run down clinics with dried pools of blood on the floor, flies swarming, and dirty needles in the trash can?  No.  There are arguments about increased efficiency and reforms to be made, I'm sure.  But let's face it.  Our care will be affected in some way. Maybe we'll have to schedule our appointments a few months in advance.  Maybe we'll see a physician's assistant or a midwife instead.  Maybe we'll have to wait a bit longer for non-emergent surgeries.

If I argue to keep the status quo, to keep the number of insured people where it is, to keep 46 million people uninsured so that I won't ever have to wait, what does that say about me?   Why are my children more important than yours?  Because I landed a good job with good benefits?  Because I was lucky enough to go to college and law school? Because I was lucky enough to have had all the privileges and parents that led to that education?

Am I better than you by accident of birth?  Should I be able to deny you health care coverage so that I can keep mine exactly as it is?

Ultimately, what the health care debate comes down to is this: Is health care a right of all Americans or a privilege reserved for those who, through luck or good health, can afford to pay for it.  In my book, health care should be a right.  What does your book say?

If you'd like to check out the Democratic candidate's health care platforms, visit the Hillary Clinton or Barack Obama websites and read more.

Stephanie can also be found ranting on her personal blog, Lawyer Mama, on a somewhat daily basis.

Comments

[jen]

brilliant, LM. brilliant. this is the crux of it - of understanding that life isn't the same for everyone, that we all don't have the same advantages, and that we are a better community if we do what we can to equal that out. and this (accessible, affordable healthcare) is an obvious, necessary way to do that.

[Nancy]

I have worked for the same company for over 20 years. They have always provided great health care coverage. Until last September.

Not that they don't want to, but with the screwed system (IMHO) coverage for 10, that just TEN employees skyrocketed to 84K a year. EIGHTY FOUR THOUSAND? And that was with a 5600 deductible and co-pays and NO drug card or eyes or dental.

Now at 53, I have a catastrophic policy I pay for myself. At $250 a month. Coverage starts when I am admitted to a hospital and ends when I walk out the door. Oh yeah, and I have a $2800. deductible.

And the real thing that sucks? I am probably luckier with this than some that have nothing and have health issues.

A right or a privilege? At this point the decision is made daily, by the system in place, who lives and who dies. Sad isn't it?

[Suz]

Exactly. It's important to put the stories of people who have coverage next to those who don't have it because that's where you see the depth of the inequity. My mother is alive today because, as a federal employee, her insurance allowed her to see one of the top cancer specialists in the nation. We have two healthy children because my husband's company covers the cost of infertility and hospitalization for a difficult pregnancy. In this country, privilege begets privilege. The more privileged you are, the better health insurance you have, the more options you have, and the less you have to pay out of pocket.

Shouldn't it work the other way around?

[Defiantmuse]

It's interesting how countries such as Canada, Sweden and the Netherlands manage to have extremely efficient and comprehensive health care coverage. But....Oh yeah, they're not spending billions of dollars on a morally corrupt war in the Middle East.

[Kyla]

Amen. You said it perfectly. Thank you.

[sher]

well done.

health care is an issue i think about daily. ok, truth be told, i obsess about it. see, i'm generally a pretty healthy person (ok, so my butt is too big, but seriously, i'm not giving up chocolate), but two years ago, my platelets decided to disappear. when i finally made it to the ER, the nurse asked me: did you notice you were tired? well, i'm a mom -- i'm ALWAYS tired!

long story short, i have a genetic condition where my immune system isn't up to snuff. every 4 weeks, for the rest of my days, i have to get hooked up to an IV of gammaglobulin. that stuff keeps me in fightin' form. that stuff also costs $5,000 **each time**. even barbie can do that math... and that doesn't include the costs of the IV tubing, the nurse, the doctor's office, etc... i had to leave my job to take care of myself, so fortunately, i am still covered under my husband's health insurance. but should something ever happen to him and his insurance? let's just say it isn't a pretty picture.

two words: pre-existing condition.

and every time i think about people who do not have health coverage, i just cry. anyone who says access to health care is a privilege clearly has never dealt with a serious/life-threatening condition.

there has got to be a change. people should not have to die simply because they cannot afford treatment.

period.

[kittenpie]

Bravo. Absolutely. Thsi is the dark side of the American Dream mythology - where if anyone can make it, then those who can't are clearly too lazy to work hard and can be left to rot in the gutter while the others climb up over them while still feeling morally superior. Sound harsh? PErhaps it is, but just listen to the rhetoric of the people who would deny others in order to preserve their own standards of living. It's unconscionable.

And while I do know one person who was rolled out of a hospital here in Canada far too early after her birth, I also know I was kept an extra day because I was having trouble establishing breastfeeding. I count her bad experience more as a strike against her particular doctor and possibly the nursing staff than against the system as a whole, because I have never heard another case like it. Even when my doctor is booked with a heavy patient load, another doctor in the practice will be on call. I have had to wait an hour or two on some dire occasions, but I have always received care the day I needed it. So yes, tell your naysayers that public health care does work when it is properly funded and is partaken in by everyone.

[Emily]

I am torn. Having lived in both the US and the UK, I know neither system is a good solution. My son (then 2) had a rash right above his XXX for six months before the NHS doctors agreed to send me to a dermatologist, and then only after I insisted because I had private insurance. And? The dermatologist got rid of it in a week. That is not decent coverage for any kid. Am I OK with my US healthcare not being quite so, um, comprehensive? ABSOLUTELY! Am I worried about ending up with a mess like NHS? ABSOLUTELY!

[Sarcasta-Mom]

This issue really hits home for me. When my husband lost his job 5 months ago, we lost our only somewhat affordable health insurance option. Since then, our family has been without health insurance, and it terrifies me every day. I work for a non-profit, and the health insurance they offer would cost more than half my pay check. I simple can't afford it.

I have been researching affordable health care options, but nothing has stuck yet. If there's any one issue that is most important to me in this election, it's the issue of health care. Hard working families, like mine, just can't afford decent health care, if any at all.

[Moondance]

You've hit upon one of my hot buttons. As someone currently working in health care administration, with a previous life in health insurance and direct patient care, I've seen this issue from all sides. I could not agree more that our system is broken.

You message that we are already paying for uninsured poeple's health care is so important. Only, the system makes them wait until it is almost too late before it gives them the real expensive care, rather than covering them before it gets to be a big deal.

Half of the people my company provides health care to never pay for it. So, of course, the other half pays, on average, twice as much to keep our doors open.

So take the money, move it into preventive care and education, and we can do more with less, while improving the quality of life for children and old people, diminishing suffering, and teaching a new generation how to take care of themselves.

[Annie]

You have hit so many nails right on the head. I have ruminated over these issues many times.

I grew up with the UK health care system, which as a previous poster said - is free but comes with a price in terms of efficiency and standard of service.

The role of the big drug companies is one I'm particularly curious about - whose pockets exactly are they in? Is their involvement one of the reasons that the system here is so bent towards treating symptoms instead of focusing more on preventative care, and treating root causes of conditions?

It is a heinous mess - and it is all too easy for those of us with insurance to say 'I'm alright jack - sod the rest of you' - but as you say - it comes down to a fundamental level of compassion for your fellow human beings, to want something better for American society as a whole.

As an outsider, I can tell you that it disgusts me that there are such levels of obscene wealth in certain sections of American society, and desperation and poverty among those simply struggling to survive.

I do not yet have the right to vote in this country as a mere legal alien - but I pray fervently that the citizens of the United States have the courage to vote emphatically for a candidate with the right priorities and one whom will effect appropriate changes, or at the very least start the ball rolling in a positive direction, since this is one big mess to sort out.

[Free Haircutter]

Imagine if haircuts were a right?

[Free Haircutter]

Imagine if haircuts were a right?

[Chelsea]

Moondance is so right. It IS a heinous mess. It is NOT a clear matter of wealth over poverty. She also raises an excellent issue re the durg companies and not just drug companies, folks, equipment manufacturers as well, who drive demand for the "latest technology" at any cost- often over the more well informed opinions of the physicians who don't need a $2,000 test to tell you its not your gallbladder- its your diet. But they don't want to get SUED- nor does their malpractice carrier- so they HAVE TO order that bleeping $2,000 test just because it's "available". Physicians have been hog-tied just as consumers of healthcare are hog-tied. You simply cannot blame "obscene" wealth or privilege. Who can be blamed are the people- manufacturers, consumers, politicians, unions, physicians, lawyers and yes, insurance companies who choose to manipulate "healthcare" to their own greedy "obscene" advantage. These are the ones who have done the greatest damage to the system. It is not the fault of those born "privileged", nor the Republicans nor any other single group of people- unless you can separate out a group as Avaricious Without Scruples- and they are to be found in every segment of our society. Spurious lawsuits, unnecessary procedures, inflated costs, and any number of other methods of fleecing the system have gotten us where we are. It would be much easier to blame one group, and much easier to solve, but greed comes in all walks of life, all political affiliations and all colors. SarcastaMom is so right, education is key, but not just information. Somewhere we must start teaching right and wrong, honesty and compassion again. Morality & ethics have gone by the wayside in a society focused on "getting ahead" at any cost. We pay athletes MILIIONS and teachers have to get food stamps to feed their families. We have lost our way, and healthcare inequities are just one sad symptom. The amount of money being handed out in big-business bailouts would amount to over 100,000 per family if distributed to American citizens instead. There is something seriously wrong here, and more government is not the answer.

[Lawyer Mama]

Chelsea - I don't think Moondance said anything about it not being a matter of wealth over poverty. You are addressing why health care costs have skyrocketed. *I* am talking about why health care *coverage* should be a right, not a privilege of the wealthy or those who happen to work for the right employer. Those are two entirely different issues, albeit two issues that both need to be addressed.

Something is seriously wrong, but insurance companies will not cover everyone unless mandated to do so. It's not in their fiscal interest to do so. If you have a way to ensure that everyone receives coverage and equal access to health care that *doesn't* involve congressional mandates, let's hear it.

[Uncle Ted]

Dear Lawyer Mama, you rock!
Lots of good comments here by some educated people, and it's time to be making some real changes in the health care system. Here's a smart, educated woman who has a serious disease. OMG, let's not cast her aside shall we. Yet the argument seems to be that those who can't afford it are not working hard or foolishly spend their money, etc. So they don't deserve benefits, or do they? The illegal aliens may be a different story, but if they are working and paying taxes here, is it fair to deny them benefits? The young and very healthy don't want to pay the cost, but they will one day need it and should have to contribute something because a societal benefit is seen from a healthier population as a whole.

[Jared Wos]

You have no understanding of right vs priviledge, let alone the constitution, let alone the definition of liberty. Public healthcare is a morally correct ideal, however it is not feasible in a fiscal sense. If democrats understood anything about the foundations of our country, they would know that we are a capitalistic nation, where anyone can come from nothing, work hard enough and buy more and better quality. We were founded upon the "American dream;"

The American dream provides the OPPORTUNITY to get anything you desire, it doesn't provide it for nothing. That is why Americans are such hard workers, its in our blood to work for what we get.

If someone is unhappy with their healthcare, then get off your lazy butt and get a better job. Sell your computer your viewing this on and buy your family coverage. It is incredible how LAZY americans are becoming, especially democrats. You should be ashamed of yourself.

4% don't have healthcare! 4% is a very, very small number. If you are part of that 4% then I am sorry for you, that is why we have Emergency rooms. You shouldn't make the entire country pay for your inability to provide for your self or your family.

You "Mom's" can't handle the fact that your president is going up in smoke because he is way to inexperienced to handle these many problems.

Read the Constitution; if it states that the government should provide healthcare to all citizens (including illegal immigrants under Obama) then I will back down from my argument. But you can't because it is not in the Constitution.

[Lawyer Mama]

Sorry, Jared. We don't argue with commenters who have spelling & grammatical errors. Or those who are condescending. We automatically assume you're ignorant.

[Jared Wos]

Drowning out opposition are we? Thank you for making such a mess of healthcare! You are making 2010 and 2012 potential great years for Republicans! Keep up the humiliating work, while we sit back and watch Obama crumble!

[Karoli]

Jared,

First, drowning you out would involve removing your post. No one has removed your post.

Second, your arguments are the same arguments made over and over since 1928. They're old, tired, and have been proven false over and over and over again.

What is remarkable to me is that all of you who claim to stand for business and free enterprise don't see the value of removing this burden from employers' (and employees!) shoulders.

It also may come as a surprise to you to know that the insurance companies *will* survive. It's amazing. They're like cats on their first life. They always survive, and find ways to profit. Don't worry, Jared. They'll be just fine.

[VoteSmartNotDemocrat]

Health care is NOT a right. Rights are freedoms of action, not entitlements to what others produce. A “right” to health care violates the rights of those who produce it. “Health care” consists of diagnoses and treatments by highly-trained medical professionals. It involves sophisticated products, instruments, and tests designed and developed at great investment, effort, and cost by scientists, engineers, and entrepreneurs. That is, people produce health care. There’s no right to health care, just as there’s no right to happiness. But the pursuit of happiness is a right. Similarly, everyone has the right to pursue medical treatment through voluntary exchange with those who produce it. We also have the right to protect ourselves against medical expenses as we see fit. Yet when politicians seek to guarantee health care as a right, they decide what qualifies as appropriate medical treatment. Whether you get the treatment you want depends on the discretion of authorities.