I had an interesting conversation with someone I do not know on Twitter when I replied to a tweet that was retweeted by someone I follow. It was about healthcare and rights. That is really what it boiled down to, and that is what I feel is the fundamental question at the heart of the healthcare debate — Is healthcare a right? And should it be?
To elaborate: As Americans we believe in certain rights, we have codified many of them in a document we call the Bill of Rights. We believe in a right to freedom of religion, press, assembly, speech and petition. We believe in a right to keep and bear arms. And we believe in a whole long list of rights regarding the legal system and protecting individuals from the government. The right to have protection from quartering of troops without consent (apparently this must have been a big deal in the late 1700s), the right to protection from unreasonable search and seizure, the right to due process of law and a speedy and public trial by a jury.
Are those the only rights that we claim as citizens of the United States? Of course not. In fact the 9th Amendment specifically states, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” So, we believe in rights that exist even though the Constitution does not specifically outline them for us. Which then begs the question — what are those other rights? How are they determined? Who decides what rights we have and what rights we don’t have? Who makes the determination as to what is and is not a ‘Right’? (I think this debate will become increasingly more important, especially since a right to privacy is not enumerated and that is becoming a huge deal in national and global politics.)
As I think about healthcare and especially the healthcare system in a America I keep remembering a PBS documentary I watched in an Anthropology class at BYU, Sick Around the World, where Washington Post foreign correspondent T.R. Reid visits five different countries (U.K, Switzerland, Germany, Japan, and Taiwan) and spoke with doctors and healthcare professionals, with legislators, and with average people and discussed their views on healthcare and how it worked in their countries, all the while comparing their systems with that of the United States. He pointed out things that worked well in each country’s system, as well as a few areas where they fell short. I would highly recommend this documentary to anyone wanting to join the conversation on healthcare.
The thing that stuck out to me about that documentary was an interview he had with the president of Switzerland, Pascal Couchepin. The president states,
Couchepin: We want also high quality for everybody in the health system. … School, healthcare, railway system, aging, to have a good place for nursing homes for old people, retired people, we think that we must have equality of that — not quite complete equality, it is impossible, but to have a great sense of solidarity among the people.”
And the interviewer follows with:
Interviewer: Now, see, that’s striking for an American, because we would certainly say everyone is entitled to an education, everyone is entitled to legal protection if you get in trouble with the law, but we don’t say that everyone is entitled to healthcare.
Couchepin: Why? Because it is a profound need for people to be sure that, if they are struck by a stroke of destiny, they can have a good health system.
Interviewer: So if you ask the people of Switzerland, is everyone entitled to decent healthcare, the Swiss would say?
Couchepin: Everybody has a right to healthcare.
That conversation has stayed with me, years after I first watched this documentary, because the reporter has a valid point. In America we believe in certain rights, but we do not believe that healthcare is one of those rights, as the people of Switzerland, and many other countries, do. And that is the difference. Because they believe that healthcare is a right, they are willing to pay the taxes, to set up the organization, to overhaul their system, as they did in 1994, to ensure that healthcare was accessible to all.
And, then this brings us to one of the other fundamental issues when discussing healthcare, and especially when we want to get the government involved — What does/should the government control? How much should the Government do to help those who find them in a position where they are not able to take care of themselves?
To be honest, I am a fan of what we call the free market system. I think that competition is a healthy and good thing for society and will generally work itself out. Customers will not pay a business that does not provide the service or good in the way they want and then that business will either fold or change and improve itself. In the same way, prices tend to regulate themselves as more competition springs up and consumers are able to choose a different company offering the same product for a lower price. But, as we look at the way the world actually works, we see that there are certain industries and fields where this does not happen, or where we do not want this to happen, areas of public interest or safety. Can you imagine if the police or fire were private companies and charged for the service they provided? Or, if there were private road companies that built and maintained roads, and you had to pay to use certain routes to where you wanted to go? There are certain services that we want to always work, despite the market, and so we are willing to pay taxes to have these regulated by the Government.
I believe that the Government should manage only that which the free market will not regulate of itself in the best way to benefit all citizens. Yeah, I know that is a very vague statement, and even I am not sure exactly what I mean by it, only that I know I want the Government managing the infrastructure, such as roads and highways, and Police and Fire, so that I will always have access to these services. In the same attitude, I believe that the government should be involved in the healthcare system, at least partially, to help ensure that exactly what is happening with healthcare in this country does not. I do not believe it is right that a person goes bankrupt due to medical costs (CNN reported in 2009 that 60 percent of bankruptcies in US are caused by medical bills). I am not asking for free healthcare for all (though that would be nice and works in other countries), I realize that cannot happen in America overnight, it is too big a change. I just believe that the Government should step in and help regulate and protect its citizens from bankruptcy simply because they happened to get sick. And I realize there is no such thing as free anything. If the Government is going to be involved with lowering healthcare costs, someone is going to have to pick up the tab, and that will be the taxpayers. Personally, I am okay with paying more tax in order to have this service, just as I am okay paying taxes to enjoy the other services that Government provides. And honestly, is it really that much different than paying insurance? You’re paying for the healthcare one way or another. But, we need to be mindful of those less fortunate than ourselves. I am willing to pay to help my neighbor. And a government-run healthcare system, in my mind, as I understand it, is like a communal insurance program. We all pay the taxes to the government, and then we use the services that we need. If one uses the service more than others, oh well, that’s the way it works. (But, in that documentary issues like that are addressed in some of these countries, where people may abuse the free access to healthcare, going too often to the doctor for needless issues, causing a drain and clogging the system for those who actually need it.)
And, let me be the first to say that I admit that the Government is not the best solution, but the free market health insurance system has not been the best solution for millions of Americans, either. Something needs to be changed, and I’m hoping we can discuss this as a nation, debate this, listen to each other, find new ideas and talk about them rationally, pointing out the benefits and detriments of each proposal, and then come to a compromise, make a decision that helps make healthcare — and I mean affordable healthcare, an accessible right for all Americans.
As I stated, it all comes down to the two fundamental questions for me — Is healthcare a right that all Americans should have access to? And to what extent should the Government be involved?
I know that I have a lot of friends who live in other countries, England, Germany, Canada, etc. I would love to hear your thoughts to this debate. Are you satisfied with the healthcare system in your country? What do you like about it? What would you change? Would you exchange it for an American healthcare system?