As the presidential election of 2008 approaches, the focus on the problems with American healthcare intensifies. Unfortunately, there are many complicated challenges facing our citizens in terms of providing first- rate yet affordable healthcare to meet our nation’s healthcare needs. As this debate has progressed, I have noticed a question that is being asked with increasing frequency. That being “Is healthcare a fundamental American right?”

As a young physician starting private practice in 1991, I passionately felt the answer to this question was no. This attitude was based on my traditional Scotch-Irish upbringing of self-reliance as well as an abiding distrust of increasing government interference in healthcare. Why should professional services such as medical care be a guaranteed right to all Americans? This is indeed a complex issue, but one worthy of study and debate.

In the 1990’s the Republicans stood firm against “Clinton Care” which was the first attempt at universal access to healthcare in our recent past. However, excluding essential groups in this important discussion such as the American Medical Association flawed this process toward “healthcare for all”. The work product of Hillary Clinton’s task force committed the nation on a path toward a single payer plan. This is another term for “socialized medicine” where the federal government pays all medical expenses for all of it’s citizens irrespective of income and thereby also controls all aspects of healthcare policy and provision. As the old saying goes “he who has the gold- makes the rules.” This was a version of government-sponsored healthcare as occurs in Great Britain, Germany, or Canada. The problem with this plan was that Americans, by in large, do not want or need the government controlling such important aspects of their lives. Americans were not and are not ready for loss of choice in their healthcare decisions, nor the rationing that is incumbent with any such program. However, the landscape of healthcare has greatly changed since the early 1990’s.

Changes in healthcare over the last ten years include the dominance of managed care and the ever-increasing cost of healthcare in America. It is obvious that we as a nation cannot sustain continued uncontrolled costs of treating the sick and protecting the health of America. Employers, especially over the past five years have been steadily shifting more of the cost of healthcare to employees rather than continue to bear the full brunt of cost escalation. As more Americans feel the pressure of healthcare costs, the need for alternative financing arises and more Americans lose the ability to afford healthcare. What are we to do as a nation? Again, the question is before us. Is healthcare a fundamental American right?

The answer to this question should not be based on political correctness or any sense of self-interest on the part of physicians or patients. Rather let us look to the founding documents of our country. Although the founding fathers probably were not concerned with universal healthcare for the country, the Declaration of Independence does express the God given right to “life, liberty, and the pursuit of happiness.” Liberty is granted by providing for the national defense and also guaranteeing that all citizens are afforded legal representation in a court of law without regard to their ability to pay. All citizens are protected by the military whether they are a taxpayer or not and public defenders are provided for those who cannot afford private legal defense. The pursuit of happiness is provided by America’s unique ability to provide opportunity for any of its citizens to succeed if they have the ability and are willing to work hard and sacrifice to achieve that success. An important aspect of providing this opportunity is by providing for the public’s education. Therefore, one could reasonably conclude that the right to life not only argues against abortion on demand, but could also argue in favor of full access to healthcare for all Americans. This is not synonymous with government sponsored socialized medicine, but rather could include any number of modifications of our current system which allows those Americans unable to afford care to have it without “dumbing down” the whole system for the rest of us. In the next commentary, we will examine the different options before us as Americans as well as the attitudes of the presidential candidates toward healthcare reform.

As we make these important decisions, we must decide what kind of society we truly are. Do we ignore the plight of millions of Americans struggling with the high cost of medical care? Do we completely morph into a completed “Nanny State”? Is there a middle ground where America can care for her own in need without losing our self-reliant independence? These should be questions we all consider before voting in November. Speaking for myself, my attitudes are changing significantly as compared to 1991.

Dr.Dan Edney

This entry was posted on Wednesday, April 16th, 2008 at 4:47 pm and is filed under Commentaries, Health Insurance, Healthcare Reform, Public Policy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.