HMOs

Is Healthcare a Right...Yet?

by: cameronpage

Mon Apr 27, 2009 at 12:08:34 PM PDT

A recent CNBC segment posed the question of whether healthcare is a right.  They brought on commentators to argue in favor and against, one from the Cato Institute and one from the National Physicians Alliance. (The segment is posted on this page below...thanks Anjali!)

The host started by posing the question to the conservative commentator, Michael Cannon. "I think it should be a right," he replied. "And therefore I think physicians should work for nothing."  Sarcasm notwithstanding, his point was clear: healthcare cannot be a right because it involves payment. The exchange of goods and services for money equals capitalism, which puts healthcare squarely in the category of commodity.

Mr. Cannon backed up his point by contrasting healthcare with other things we commonly think of as human rights, like freedom of speech and religion.  No one has to be paid in order to let us speak freely and worship freely, he implied, which is why they are rights and healthcare is not.

This argument is persuasive. We like to think that a human right is something you are born with, not something that has to be given. The very phrase 'freedom of speech' suggests its simplicity: just let people speak!  It's not that hard!  Healthcare, on the other hand, is not accomplished by standing aside and letting citizens exercise their freedoms. For healthcare to be your human right, something has to actively be done to you.

But is it true that freedom of speech requires no involvement by the government? Let's imagine taking a trip to place where there is very little government, for example Somalia. You might have the basic human right to freedom of speech there, but it's not worth much. If you stand on a milk crate (assuming you can find one) and give a speech that others find disagreeable, those people may choose to gag you, stuff you in the trunk of a car, drive you 20 miles out of town, and perhaps kill you. The government has done nothing to take away your freedom of speech, but they haven't done anything to protect it either.

We often ignore the role of infrastructure, such as our police force and civil and criminal court system, in allowing rights like freedom of speech and religion to flourish. The U.S. legal system is a highly complex bureaucracy, and it plays an important role in keeping the right to free speech alive.

The same principles apply in healthcare.  We have a complex bureaucracy in place --- doctors, nurses, hospitals --- to protect our right to health.  There's no difference, in principle, between free speech and healthcare, so why is one an unquestioned human right while the other is relegated to a commodity?

In fact, no matter what human right you can name, there is an infrastructure in place to protect and defend it.  And the professionals who manage that infrastructure need to get paid.  So it's foolish logic to argue that since doctors are paid a salary, healthcare cannot be a right.

There's More... :: (1 Comments, 447 words in story)

Why It's Time II: second verse same as the first

by: cameronpage

Wed Jan 07, 2009 at 13:54:31 PM PST

I have a patient with hepatitis C. She had some signs of cirrhosis (fibrosis in the liver, which is one of the effects of the virus), and she wanted to get treated, which usually requires a liver biopsy. So I referred to the liver clinic.

They sent her back to me saying that she needed an ultrasound beforehand. The ultrasound showed a possible mass, which could be liver cancer (hepatoma). In my discussions with the liver people we decided that she needed an MRI to rule out the hepatoma before moving forward with her Hep C treatment.

So like a good little monkey, I ordered her an MRI, filling out all the forms and getting all the prior approvals, kissing all the rings on all the HMO fingers.

But since it wasn't an emergency, they gave her an MRI date five months in the future.

One week before she's supposed to get scanned, I am contacted by the MRI techs. Why? Her ultrasound (remember that?) is now TOO OLD, so she needs to get a new ultrasound before she can get her MRI.

So okay. That would be a good end to the story: unnecessary bureaucracy causing the need for multiple imaging, the waste, etc etc.

Except that's not the end of the story. Because of course, it's impossible to get an ultrasound in one week, so she ends up missing the MRI appointment that it took so long to get. Now it'll be God knows how long before she gets scheduled for another MRI. (And by the time it rolls around, the repeat ultrasound i'm getting today will be outdated. Repeatedly. Again.)

All this time, there might be a liver cancer growing in her belly.

Could a thing like this happen under another system of healthcare? Absolutely. Might a single-payer system require non-emergency MRIs to wait a few months? Of course.

So really, this story is for those who live in fear that single-payer healthcare will give us long waiting periods. Let's be clear about it: we've already been given long waiting periods. The HMOs gave them to us.

But what the HMOs giveth, we can taketh away. We just have to decideth to.

Discuss :: (0 Comments)
About
What is health justice? How are health & human rights fiercely connected to the wellness of our neighborhoods? How do we reframe policy debates? How do we continue dreaming and building instead of just reacting & surviving? And how do we support each other in our healing?

Cure This is an online space for storytelling, discussion, & radical transformation. Create an account to write a diary or comment. Questions or thoughts: lotusfeet [at] hotmail [dot] com

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