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A Fundamental Right?

A reader recently posted a thought-provoking comment – one that I believe many of you may have considered.  The question: “Is healthcare a fundamental right??

The answer, I think, is that we must view basic health care in a similar way that we see defense and public safety in this country. We have collectively decided as a nation that providing these services and sharing the burden of paying for them just makes sense.  Health care is the same.  The costs of not providing access to basic health care services are simply too great – similar to not building guardrails on our highways or having a fire department to extinguish flames that could overtake entire cities or building an army to ensure the safety of our citizens.

Basic health allows people to lead productive and positive lives, support their families and contribute to their communities. To have a successful economy and productive workforce, America needs for its citizens to be able to take care of themselves and those that they bring into the world.

Preventative medicine and measures that promote early detection of disease such as basic dental services, nutrition education, mammograms, colonoscopies, pap smears and immunizations – these all make sense from a public health standpoint. When people do not have access to health services and screening tests, highly treatable diseases like prostate or cervical cancer are diagnosed at later stages when often the only course of action is to provide life saving treatments.  This type of care is very expensive; tremendous resources can be saved by promoting screening tests to catch these diseases in their earliest stages.

However, deeming basic health care a responsibility of the government should not give everyone the right to be treated for every ailment and complaint.  Basic health care should not encompass procedures and measures that are considered elective.  Coming to an agreement on what constitutes basic health care will obviously not be a simple task. To avoid implementing arbitrary, bureaucratic standards, we must empower our scientists and clinicians – not lawmakers – to make these decisions.  Fundamental groups in the field of education have established fairly universal criteria for what constitutes a college degree, and I am confident that the best minds from the health care industry, public and private, can achieve the same for health care.

I frequently say that health care reform must happen.  I continue to repeat this statement because I truly believe that we can’t afford for it not to happen.


2 thoughts on “A Fundamental Right?

  1. Dr. Atkinson,

    Thank you for responding to my first post. Unfortunately, I must respectfully disagree with you about the fundamental rights argument on a couple of fronts.

    Firstly, you compare health care to national defense: when we’re lacking in soldiers, we’ve instituted the draft. To this day, every male citizen must register with Selective Services when they reach 18 years old. What do we do if we find ourselves lacking doctors, nurses and techs, as we see in other national health care nations? Start drafting? Is America going to get into the business of providing incentives for people to go into the medical field? The results of that is never the best or brightest.

    Secondly, you go on to say, “America needs for its citizens to be able to take care of themselves and those that they bring into the world.” I whole heartedly agree here, but do the bills in congress and what we hear from the president fit this prescription? Just yesterday our president told us that national health care would be funded by increasing the taxes on the highest income earners. Is this our citizens taking care of themselves? Or is living at someone else’s expense just the opposite of personal responsibility? “Should I quit smoking? Nah, Dr. Atkinson will cover my treatment costs anyway.”

    And who are these highest earners exactly? Doctors – we’re going to tax doctors more for the privilege of an increased work load? Business people who research and develop everything from our modern convinces to the latest in diagnostic testing and prescription drugs? Is it surprising that America, as opposed to the socialized medical care nations of the world, create the vast majority of medical advances? It’s not by magic. These highest income earners, who often already give most of their income to taxation, aren’t our enemies nor should they be our scapegoats. We should be getting out of their way, so they can do what they do best, and encourage others to do the same. That isn’t done by increased taxation.

    Thirdly, you say that preventative screening will decrease our health care costs. Certainly, catching highly treatable diseases early will decrease the costs… in regards to that single patient. The Congressional Budget Office, however, is estimating the increase in preventative screening to increase, not decrease, overall costs of medical treatment in America. That is, even catching the odd patient here and there and the costs avoided, does not offset the cost of screening every person in the nation for every disease they’ll never catch.

    I will agree that healthcare reform is something that will have to come, sooner or later, but I disagree heartedly with the way in which we’re going to allow the government to come even further into the picture.

    We could be asking why insurance costs are so high; is it possible that increases in costs can be attributed to government intervention already? From state to state we find varying requirements for the insurance industry. In many places a newborn girl is required to have pregnancy coverage from day one, if she has health insurance. She can’t opt into it at, let’s say, an age where pregnancy is possible. Most places (if not all) require everyone with insurance to have drug rehab included, regardless if they want or need it… When the state tells us what we must have if we want any health insurance, how exactly do we expect health insurers to be able to dramatically lower their costs or have an atmosphere of competitive business?

    All over the country we have family practices that don’t accept health insurance at all. Because they’re not spending hundreds of thousands of dollars a year on the overhead associated with it, and because they’re not compensated by whatever the insurance provider decides they should get, they wind up charging their patients dramatically less than we find at offices that do accept insurance.

    It would seem to me that lower costs (and wider availability that comes with it) for routine medical care would be something we should be working toward, not away from. Especially when we can see the results of the road we’re headed down all over the world: decreased levels of service, rationed care, waiting lines and fewer medical advances.

    I’ll concede that all these things may not result from the bills currently in congress, but why would we want any of them? Why would we want to go down that road when there are other options of reform? You don’t hear about them from politicians (any politicians) because any other road would lower their control, not increase it, but that’s no reason for other options not to be discussed in the public forum.


  2. Jeff,

    I do agree with the fact that access to health care should be a fundamentall right. And that this requires governmental control, because assuring fundamental right is not to be left in the hands of the private sector for which profit is the number one consideration, while the health of its patient is not.

    When Jeff says that European systems create, rationed care, fewer advances, decreased level of service and waiting line….. well he is just plain wrong. I have first hands experience with one of those systems as I have emigrated from one of those countries, and the quality of care, the number of highly technological advances, and the waiting lines at the doctors are the same. I would actually say that the quality of care is superior to what is found in the US…. and I do have health coverage. Are those systems perfect? Of course not…. but the american one is broken. I do not claim to know exactly why? But the truth of the matter is that every year, cost of insurance increases and coverage decreases. It is this very country (US) that has a decrease in the quality of care.

    As for waiting line? Well, let’s see….. if I want to get a family doctor I have to wait around 6 month to be admitted as a new patient. What is that for a waiting line?
    What about choice of doctor? Most insurance compagnies decide for you which local doctors you can go see. And if you have an HMO…. well, you do not even get to choose at all.

    Doctors are not to blame, but insurance companies are. My health is basically used as a comodity to be auctioned by insurance compagnies. It seems, from reading your post, that you wish to deregulate the insurance companies and let them do pretty much what they want. We know from past history that this will fail.

    Now I do not claim we should switch immediately to one of the functioning European system. The social cost would probably be too great as the health care business employs a lot of people. But more government involvement is needed because my health should not be a ressource to be exploited for business benefits. We need to find an american solution. And to tell you the truth I do not necessarily know it, but to dismiss any form of socialized medicine out of the bat based on faulty information of what is going on abroad is irrational.

    I think we should make clear comparison of what is going in other countries. There are many models of health care systems (one per country really). Let’s get the truth about the status there, and then see where we stand and adapt a model we think can work to this country.

    Just my 2 cents.

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