Is Healthcare a Right...Yet?

by: cameronpage

Mon Apr 27, 2009 at 12:08:34 PM PDT

The host started by posing the question to the conservative commentator, Michael Cannon. "I think it should be a right," he replied. "And therefore I think physicians should work for nothing."  Sarcasm notwithstanding, his point was clear: healthcare cannot be a right because it involves payment. The exchange of goods and services for money equals capitalism, which puts healthcare squarely in the category of commodity.

Mr. Cannon backed up his point by contrasting healthcare with other things we commonly think of as human rights, like freedom of speech and religion.  No one has to be paid in order to let us speak freely and worship freely, he implied, which is why they are rights and healthcare is not.

This argument is persuasive. We like to think that a human right is something you are born with, not something that has to be given. The very phrase 'freedom of speech' suggests its simplicity: just let people speak!  It's not that hard!  Healthcare, on the other hand, is not accomplished by standing aside and letting citizens exercise their freedoms. For healthcare to be your human right, something has to actively be done to you.

But is it true that freedom of speech requires no involvement by the government? Let's imagine taking a trip to place where there is very little government, for example Somalia. You might have the basic human right to freedom of speech there, but it's not worth much. If you stand on a milk crate (assuming you can find one) and give a speech that others find disagreeable, those people may choose to gag you, stuff you in the trunk of a car, drive you 20 miles out of town, and perhaps kill you. The government has done nothing to take away your freedom of speech, but they haven't done anything to protect it either.

We often ignore the role of infrastructure, such as our police force and civil and criminal court system, in allowing rights like freedom of speech and religion to flourish. The U.S. legal system is a highly complex bureaucracy, and it plays an important role in keeping the right to free speech alive.

The same principles apply in healthcare.  We have a complex bureaucracy in place --- doctors, nurses, hospitals --- to protect our right to health.  There's no difference, in principle, between free speech and healthcare, so why is one an unquestioned human right while the other is relegated to a commodity?

In fact, no matter what human right you can name, there is an infrastructure in place to protect and defend it.  And the professionals who manage that infrastructure need to get paid.  So it's foolish logic to argue that since doctors are paid a salary, healthcare cannot be a right.

The Fight Will Be Dirty

by: cameronpage

Tue Apr 14, 2009 at 12:13:32 PM PDT

"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence.

Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune.

...

The letters were, in fact, composed and sent by the Boston office of [Dewey Square], a national political consulting firm, attempting to create the appearance of a "grass-roots" movement for Medicare Advantage.

America's Health Insurance Plans, an industry trade group, hired Dewey Square to defend the Medicare Advantage program.

It gets worse:

The Eagle-Tribune received a call from a man who turned out to be an intern at the Boston office of the Dewey Square Group, a national political marketing and consulting firm.

The man, who identified himself as Noah, wanted to know if Gloria Gosselin's letter had been published. Asked what interest he had in the letter, Noah replied that he was Gosselin's grandson.

Gosselin does not have a grandson named Noah working in Boston. Her only grandson is a student at Central Catholic.

Got it?  The fight will be dirty.  AHIP knows that to block healthcare reform, they will have to get rough.  And they're not going to sit back and let the groundswell of support for healthcare reform wash over them.

Conservative estimates are that AHIP has $100 million set aside to fight against healthcare reform.  And they seem to have every intention of playing dirty with it.  

So this is it.  We've been warned.  Consider this a shot across our bow.  It's going to be a serious, heavy-duty fight.  

And if we fail to reform the system because we don't fight back hard enough.... well, i was going to say we have no one to blame but ourselves.  But we can always blame the big bad insurance industry.  We can fail, and then we can comfort ourselves that they had more money, and they played dirty.

But I'd rather not comfort myself.  I'd rather win.  And we can.  We have the truth on our side, and better arguments, and oh yeah, history is on our side too, both in the U.S. and around the world.  Those are far more powerful than a willingness to play dirty.

Smears can always be defeated by the truth. But someone has to speak that truth.  Unfortunately, it never speaks for itself.  

Why It's Time II: second verse same as the first

by: cameronpage

Wed Jan 07, 2009 at 13:54:31 PM PST

They sent her back to me saying that she needed an ultrasound beforehand. The ultrasound showed a possible mass, which could be liver cancer (hepatoma). In my discussions with the liver people we decided that she needed an MRI to rule out the hepatoma before moving forward with her Hep C treatment.

So like a good little monkey, I ordered her an MRI, filling out all the forms and getting all the prior approvals, kissing all the rings on all the HMO fingers.

But since it wasn't an emergency, they gave her an MRI date five months in the future.

One week before she's supposed to get scanned, I am contacted by the MRI techs. Why? Her ultrasound (remember that?) is now TOO OLD, so she needs to get a new ultrasound before she can get her MRI.

So okay. That would be a good end to the story: unnecessary bureaucracy causing the need for multiple imaging, the waste, etc etc.

Except that's not the end of the story. Because of course, it's impossible to get an ultrasound in one week, so she ends up missing the MRI appointment that it took so long to get. Now it'll be God knows how long before she gets scheduled for another MRI. (And by the time it rolls around, the repeat ultrasound i'm getting today will be outdated. Repeatedly. Again.)

All this time, there might be a liver cancer growing in her belly.

Could a thing like this happen under another system of healthcare? Absolutely. Might a single-payer system require non-emergency MRIs to wait a few months? Of course.

So really, this story is for those who live in fear that single-payer healthcare will give us long waiting periods. Let's be clear about it: we've already been given long waiting periods. The HMOs gave them to us.

But what the HMOs giveth, we can taketh away. We just have to decideth to.

'Illegals' and healthcare

by: lindarella

Fri Sep 28, 2007 at 23:27:50 PM PDT

I am going to step beyond economics of cost-containment, budgets, and the legislative process in order to break things down to a more human level.  Much popular sentiment these days suggests that society should not be held responsible for 'illegal immigrants', and that these folks do not 'deserve' what we have.  I want to point out how insidiously evil is this sentiment.  Citizenship does not trump humanity or being humane.  As a physician who treats citizens and non-citizens ('illegals') alike, I propose that it nothing short of barbaric to suggest that we can deny healthcare to a particular group of people based on their latitudinal and longitudinal position on the globe.

Consider a patient I had today.  She was a young woman from El Salvador, exactly the same age as me.  She came to the hospital with abdominal pain and weight loss, and today the pathologist read me her diagnosis:  metastatic cervical cancer, stage 4.  When I went to her bedside to give her the news, a rush of tears rolled down my face as I explained her diagnosis.  I couldn't stop thinking about her two young sons who were at her bedside the day before.  She has a terminal disease at age 33 that is completely preventable, and we cried together with the knowledge that her young ones will soon be without a mother. 

At the end of our conversation, she thanked me.  I have no idea why, because I am left with the guilt and shame that I am a part of a health care system that denies access to millions of people, citizens and non-citizens alike.  Day after day I see how this results in preventable human tragedy.  My patient is dying simply because we have collectively decided that we do not want to spend the trivial amount that it would have cost to prevent her inevitable and untimely death.  Furthermore, we tell ourselves that people don't deserve to get healthcare because of where they were born. 

I wish that those individuals who hold these sentiments would do my job for one day.  Are those who wish to deny access to healthcare really asking me to selectively treat individuals based on where they were born?  Who gets to decide who is a human and who is not, and who deserves to live and who deserves to die?  Because this is the real issue.  I believe that when faced with the reality of a sick or dying person in need, there is no other choice than to offer medical care, despite one's political philosophy or understanding of economics. The issue at stake- human suffering and the human condition- transcends politics, legislation, and the almighty dollar. 

A person's citizenship has nothing to do with physiology, the pathology of disease, or clinical judgment.  I wish that as a doctor, I worked in a system where I wasn't asked to think about such things.  A system of universal access to health care allows such a world to be possible.  For this reason and many others I propose it  to be the most humane and civil approach to health care.  I hope we can one day soon rethink our priorities and change healthcare for the better.