A moral question: Who deserves what health care?
Former Colorado Gov. Dick Lamm has taken a bold step in engaging people in discussion around the true substance of health-care reform. While his ideas border on philosophical, the implications are very real.
While presidential candidates from both sides of the aisle struggle to convey their own version of win-win coverage, Lamm hits the issue of health-care entitlements right between the eyes.
Why is his approach an act of bravery? Because in doing so, he raises intensely sensitive implications about who should get what kind of care. Let’s consider a couple of examples.
An 80-year-old woman is diagnosed with a rare form of lymphoma that ultimately will be terminal. Without a costly regimen of medications, she will die within weeks. With the drugs, her life expectancy is extended six to 12 months. The medicine will cost $40,000 for a six-month supply, but the woman is on a modest fixed income, dependent upon Medicare for her coverage.
A 5-year-old boy has a congenital heart disease that is causing the faulty organ to shut down. He is a candidate for a transplant, although the odds of surviving more than a few months after the surgery are 50-1. The cost of the surgery is in the hundreds of thousands of dollars, and the transplant organ is available, but the parents of the child are quickly reaching the coverage limits of their company insurance policy, and have no savings to pay for the operation.
Our initial reaction is to say that if the resources are there, we should do everything in our power to save, improve the quality of, or at least extend lives. No one wants to be in charge of telling a family that their parent, child or spouse will not receive care that might save them because of cost. For some, the valuation of life in terms of dollars and cents is callous and wrong. So instead, let’s consider it in more human terms.
The Center for Health Care Policy Research and Analysis reports that 18,000 people die annually in the United States because of inadequate basic health care. Meanwhile, Lamm notes that the sickest 1 percent of Americans account for 27 percent of total health-care costs. At what point do we cry foul, suggesting that just maybe we have our priorities out of order?
Let’s consider the two anecdotes above in another way. The woman facing terminal lymphoma who receives $40,000 worth of meds results in a trade-off, resulting in a lack of prenatal care for half of a dozen young women without insurance.
The cost of the young boy’s high-risk transplant means that a clinic in downtown Chicago will not be funded, resulting in hundreds of homeless people not receiving basic checkups and preventive health care. The long-term costs of hospitalization and other care for the health problems that could have been avoided escalate into the millions over the next 10 years.
Where does the moral social responsibility lie? At what point do we put our foot down and say this life deserves care and that one does not? Given this context, is it any wonder so few political incumbents or challengers want to tread into this moral quagmire?
Lamm has his finger on the pulse of a systemic issue that will have to be addressed before any substantive reform can take place.
As a society, we must come to terms with what is more important in the health-care service delivery system, drawing clear limits around what is publicly subsidized and what becomes the private responsibility of the affected family. On a case-by-case basis, this will be a bitter pill to swallow, but it will test the mettle of those who proclaim that health care for all is of paramount importance.
In a time when our state is debating the merits of a handful of so-called universal health-care plans, we’re still skirting around this more esoteric, and emotionally charged, gorilla in the middle of the room. One place where such dialogue can and should begin is in our local faith communities. If the preciousness of human life is contemplated any more thoroughly than within the medical profession, it’s arguably within the walls of our churches, mosques and synagogues.
Who would Jesus/Mohammed/Buddha cover?