In the story of healthcare reform we currently await the deliberations of our U.S. Supreme court as to the constitutional legitimacy of the Affordable Care Act* and what is being referred to as the individual health insurance mandate. At times this process has seemed to move remarkably fast and at others it has remained mired in process that leaves many wondering how to plan for the future and live in the present. Throughout the entire process there continue to be dichotomies presented for our consideration. Is the affordable care act constitutional or not? Is this a republican plan or a democratic plan? Is the direction of healthcare reform good or bad? Is healthcare a right or a privilege?
I would like to present another perspective to consider this last question. I find that binary choices can be helpful in discussing a concept, but rarely are useful to accurately represent the reality of perspectives that exist. I believe healthcare is a need, not a right or a privilege. It is a personal need for the self and it is a need for the community. In the United States of America we have created a complex often cumbersome system of healthcare finance. This system is currently not available or relevant to all Americans let alone all people living in our country. Nonetheless, the amount of infrastructure and effort that has gone into creating this system justifies the proposition that healthcare is a basic human need. I would suggest that it is not far from food and shelter in our hierarchy of needs.
We need to know that when we feel ill or hurt that there is somewhere we can turn for help. We need to know that when family or friends feel sick, there are those that can and will help. I believe our minds even require the knowledge that when we see someone that we don’t know who clearly is ill or hurt we need to know that they are able to get the care that they need. I would even like to believe that our health is valuable enough that as our other essential needs are met, that we are willing to spend energy to preserve the health we have (although I might be dreaming a bit on this one). All of you who are taking time to smoke less, eat better, and exercise more are helping to support this dream of mine.
This need is exactly the reason that insurance as a concept carries any weight. In its initial theory, we pay for insurance not because we need care at that moment but because we need to know that the system will be there for us if we do. From that initial concept of providing a need through an insurance based financing system, we have gotten far afield and created a complex and cumbersome – somewhat inaccessible model. As I have said before, I believe the Affordable Care Act moves us in the right direction. It is not clear to me the best way to structure the finances of healthcare, but it is clear to me the system we have created is not working well. Regardless of the decision of our Supreme Court, I have no doubt that our country deserves and demands an improved system. I am certain that I will continue to work towards it and I hope you will consider joining me.
I recently learned of an interesting series of community discussions happening throughout Minnesota. The project is called Citizen Solutions. Perhaps you already have read about it. These discussions will continue through June in person and online. You can learn more about this opportunity to help solve one of the most pressing challenges of our state and country at http://health.citizensolve.org/. Perhaps you will take the time to join the conversation and keep it moving.
* Since publication of blog the supreme court has upheld the entirety of the Affordable Care Act as being constitutionally sound.