Wednesday, June 28, 2017

Fundaments I: The Essence of Healthcare

In general, I steer clear of overt political statements. This in itself is a political stance in a time of hyperpolarizaion. Politics is not what this post is about.

The problem with Healthcare (capital H) is that the term has been politicized to the point that you almost have to shade the word red or blue whenever you write it. Like many words today ("liberal" and "conservative" being two obvious ones in this context) it has lost its meaning in the jumble of policy and polemic that usually accompanies discussion. Talking about the Dread Healthcare means taking a stand for or against one administration or the other; one law or another; one belief system or another.

None of this could be further from the fundamental definition of healthcare. There is nothing political about giving or receiving medical or wellness assistance - it is a normal human activity and in all probability has always been so. Ancient Egyptian mummies show signs of medical intervention and even earlier human remains show that the species has always tried to fix what was physically wrong.

Skull from Early Dynasty Egyptian tomb showing cranial trepanation during life.

In point of fact, the actual act of providing health care is no different now than it was in past centuries. An ailing soul presents to an individual who has some interest (if not expertise) in medical care. The provider assesses, diagnoses and lays on hands in an effort to cure. The laying on may be surgical or prescriptive or acupunctural or spiritual. The essence is the same.

The controversy is not about how the care is done or whether it is done at all. It lies in who can access the care and how it will be paid for. I'm quite sure our earliest ancestors felt the same way as we do, arguing about how long they had to wait in a drafty cave and how many bird eggs the shaman demanded in payment for the intervention. Humans always will question value.

But to lose the essence of medical care as we are now doing in the convolution of policy and economics is both short sighted and dangerous. Any law or any regulation should be written for the express purpose of facilitating the basic practice of medicine. Any law or regulation that interferes with this process or makes it harder to attain the care needed must be discarded.

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