Wednesday, August 9, 2017

Fundaments II: The Societal Importance of Healthcare

I hadn't even put my soapbox away from the other day and now I find another use for it.. It's too tempting to climb onto it and make one more pronouncement.

The most frequent question asked about Healthcare today (and by "Healthcare" I mean access to and insurance for) is whether it is a right or a privilege. Without staking out either side of the proverbial aisle or commenting (for now) on the means of providing healthcare, I will state that this debate misses another definition, probably the most important one. 

There is no question that Healthcare is a responsibility.

From a societal standpoint, it is not a matter of whether we can afford to pay for access to proper medical care, including both preventive and responsive treatment. It is whether we can afford not to.
Uninsured medical care is a huge burden on the financial well-being of this country. The mere fact that you don't have insurance does not protect you from medical calamities. Accidents and illness must be treated whether they can be paid for or not. Our society in its civilized state has quite rightly accepted this as fact. But even if you believe insurance is "fake money" the resources used to care for the sick and the injured are very real. Real instrumentation, real medicines, real space and real manpower are utilized. The money to pay comes out of taxes, charity funds and federal grants-in-aid. In other words everybody pays when patients are uninsured.

Beyond the financial issues though are the rather terrifying public health ones. There are few areas of the country where people can truly retire from the world. Some folks may have cabins in the woods or yurts in the dessert. But the vast majority of Americans, even in rural parts, live in defined municipalities. Most have some shared water source, shared public space (schools, church, stores) and some need to interact on a regular basis with other citizens.

Can you imagine a country where medical care is unavailable or ignored? A country where infectious disease is untreated despite continued social interaction? Where the contamination from illness is left uncleaned and unmanaged? You don't need to have too vivid an imagination to see the results. It has happened in this country. Google the Spanish Influenza of 1919 or the Polio Epidemics of the '30s and '40s. Imagine what SARS might have been or Ebola without proper healthcare and containment.

These are horror stories but not scare tactics, unless you are one of the growing number of young and healthy folks that is convinced that they will remain healthy and immune forever. Only if you can promise that you will never get meningitis or hepatitis, never fall and have a head injury, never be struck by a car or a falling object, then you need not buy into the societal protection that is insurance. But only in those remote shacks or distant huts can you assure that you will never burden a community with the detritus of your health issues. Even then, the mountain, forest and desert are interconnected ecosystems. They can be poisoned by death and disease as surely as a village, town or a city.

Not having insurance when you can is a personal choice but a uniquely selfish one. Not providing the means of access to healthcare to large portions of the population is a cruel and dangerous mistake.