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10 EXCELLENT REASONS FOR NATIONAL HEALTH CARE |
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Afterword James Winkler It sometimes seems to me there are two ways of looking at the world. Either you believe we are all in this together and we need to care for one another or you feel that life is nasty, brutish, and short and you can rely only on yourself, your family, and those like you. In a moral society, we are all in this together. In a moral society, everyone has a right to health care. The tragedy -- and the promise -- of America at the turn of the twenty-first century is that both ways of looking at the world have strong proponents. Fifty years ago, despite Congress's failure to legislate national health care, there were understandings of moral behavior to one another that were largely shared by the broad American public. Hence the subsequent advances in civil rights and the rights of women. In the interim, powerful ideological forces have not only captured significant arenas of national leadership, but through their control of the corporate world have also promoted an ideology characterized by few rights and their corresponding social responsibilities. Whether one names this ideology neoconservatism or social Darwinism, at its heart it is alien to American ideals, because in its admiration for the individual who with little assistance from others achieves material success, it looks on the person in need -- whether through poverty, misfortune, or disease -- as being intrinsically undeserving. In a moral America, health care would be a right. In a moral America, we are all in this together. A government-managed single-payer financing system is the only credible means by which the entire population can have equitable health care. The idea that we're all in this together is not new to America and it is not new to the world. In the wake of the horror of World War II, many countries of the world decided that we needed to stand together and protect and care for one another. The Universal Declaration of Human Rights, adopted by the United Nations in 1948, declares, in part, "Everyone has the right to a standard of living adequate for the health and well-being of himself and his (sic) family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control." The failure of the health care system in today's America to meet the universal ideals intrinsic to human rights and religious morality extends beyond the injustice of unequal access and taints even the nature of the care that is delivered. The provision of health care in America has been subverted from a calling to a commodity measured in patient encounters, tests performed, medications dispensed, beds filled, and above all, to profits distributed to the CEOs and stockholders of hospital corporations, pharmaceutical giants, and health insurance conglomerates. In the process, quality of care suffers as the primary consideration is often cost, not care. The physician-patient relationship has been perverted, transformed from a caring relationship into a series of billable events. The physician-patient relationship is thereby compromised not only by the physician's motivation to sell the greatest number of services, but also by the motivation of insurance companies to pay for as few such services as possible. It has been estimated that today's physician spends about one third of his or her time satisfying insurance company regulations and seeking approvals for treatment, time the physician could be spending with patients. Managed care companies, HMOs, PPOs, and the like interfere with the physician's ability to develop comprehensive treatment plans for his or her patients. High premiums force people to choose between health insurance and sustenance, housing, or other needs of a family, making even basic health insurance too expensive for an average individual or family. More than half of all personal bankruptcies are now the result of illness. Even individuals with ostensibly good insurance, let alone those who are uninsured, find themselves in situations where they must sell or spend all assets, including homes, in order to qualify for Medicaid and restore any medical coverage at all. Several years ago, I was in Norway for a conference. One evening, I walked back to the hotel with a Norwegian. He said to me, "If you slip and fall and break your head open, our nation will care for you as we do for our own people. But if it were to happen to you or me in your own country, we would have to prove we have private health insurance just in order to receive medical assistance. Tell me, what is wrong with you people?" What is wrong is that we are failing the test of social responsibility. There is something wrong with a society that has the means to provide health care for its entire people but refuses to do so. Dr. Martin Luther King Jr. warned, "A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom." These many years later, tens of millions of Americans do not have health care coverage. The great religions of the world affirm that all people are connected to one another, that nature must be sustained and cared for, and that the conditions for a good life must be provided by society. Those in power in the United States, however, promote an "ownership society" that thinly veils the notion that all rights belong to the well-off and none belong to those who find they have nothing. Civil and human rights have never come without a struggle. In most developed countries, the struggle for health care coverage has been won. Health care is recognized as a societal responsibility. The fight continues in the United States because of the power of greed. However, the insurance companies have overreached, their greed results in misery and suffering and causes millions of Americans to suffer terribly, and thousands to die prematurely. A single-payer health care system will entitle all persons within the borders of the United States to the provision of health care services, the cost of such services to be equally shared by taxpayers and the government and distributed to providers in a coordinated, comprehensive, and equitable manner. We really are all in this together. _______________ Note: James Winkler is the General Secretary of the General Board of Church and Society.
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