A Simple Choice

It might be a question of priorities, or part of my outlook on life, but I stand with the idea that healthcare is a right, not a privilege. What that means for me is that the government, in some form or another, needs to ensure universal coverage and services at the highest levels possible today.

By now everybody has heard of the famed lament of our new president about how complicated the topic of healthcare is. I don’t think it’s complicated at all. What’s complicated is settling the philosophical debate about who is responsible for managing it — the government, or the private sector.

Once that is agreed, the rest falls into place.

I come from a family of doctors. Healthcare has always been available to my family and me. Both my mother and father saw helping people in need (sick people) as their duty and as a noble pursuit. They derived a salary for their services, of course, but they didn’t help people because they were paid. I come from Romania, a country that used to be communist and where healthcare was (and is) guaranteed (I don’t want to dwell on the quality of the available healthcare in Romania at the time I lived there, compared to the developed world of today, but the basic idea was right). I have lived in other industrial democracies like Israel and Denmark, where again, healthcare was available for everybody, thirty and forty years ago, as it is today.

On a visit to Israel about ten years ago, a relative of my wife’s didn’t believe me when I told him that in the United States of America, in the 21st century, there were over forty million uninsured. Universal healthcare was so ingrained as a part of his value system that he simply couldn’t comprehend. “You lie,” he told me. A friend of ours in Sweden suffered a stroke that left her paralyzed on the right side. After many months of treatment and therapy she recovered almost completely, but she continued to drag her right foot, and had a hard time climbing the steps to her apartment on the fourth floor in an old building without an elevator. The state provided her with a free motorized wheelchair, and moved her into a similar apartment on the main floor in an assisted living facility, where she pays a reasonable rent. Moreover, she sold her old apartment, and kept the money. In Paris, we know a woman who was treated for breast cancer, and the state covered the cost of treatment plus her regular taxi rides to the local clinic for chemotherapy. One of my childhood friends who lives in Germany, a grandfather now, told me the pediatrician comes to the house when the grandchildren are sick. I know a lady who sprained her ankle during a trip in Australia. At the hospital they put her in a soft cast, and when she asked what the charges were she was told: “Nothing, you are a tourist.” People I know through work in Canada buy the same drugs we buy at less than half of our out of pocket prices. And while I’m at it, let me say that recently I learned that in Germany, universal healthcare was instituted at the end of the 19th century.

Clearly my position is not new, and the differences between our healthcare system and those in other industrialized countries abound, and not in our favor.

Several days ago, after the republicans in the house passed the measure to repeal and replace the Affordable Care Act, I listened to a debate on CNN. Somebody stated that if nothing else, the ACA has grounded the belief in America that healthcare is a right. To that, one of the pundits — I guess representing the conservative (republican) point of view — asked ironically why the government shouldn’t also guarantee a house for every citizen. Well, to be honest, that would be great, but that’s the wrong question to ask. It is the wrong analogy, and it underlines the limitation of the counterargument. You can live (decently, and sometimes very well) in a rented apartment or a house; but you cannot rent your health.

Clearly it comes down to the involvement of the government in our lives — roads and bridges, defense, education, policing, consumer protection, voting, human rights. In my opinion, as societies grow and become wealthier and more complex, the responsibility of the government increases. The laws of the jungle are too crude to apply without some level of intervention.

If we agree that our safety is clearly a government responsibility, wouldn’t keeping the population healthy be a part of it?

There are some (hopefully not many) who want to cut the role of the government to bare bones. To those I suggest a short trip to Somalia. I hope most others think like me. They understand that alone one has no chance against the grip and lobbying power of large for profit corporations (like the health insurance companies) that exist to make money from our medical needs, but together we do.

The pundit on TV who sarcastically asked if the government should now give a house to everybody, would have asked the same question decades ago, when the idea of mandatory high school education was first implemented. Nobody doubts the wisdom of that policy anymore. In fact, there are those who argue that to a large degree higher education should be free as well.

Also on TV, a British woman said that universal healthcare is civilized. I agree with her. I think that universal healthcare, like high school education, is a right, and I want my country to be civilized, too.

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