Sunday, November 8, 2009

Health care and the soul

What does my father's recent heart attack and a New York Times interactive have in common? Little, except that they both have me thinking about health care at the moment, framed in the context of morality.

First, dad. Mom drove him to Medical Center of Arlington a week and a half ago after pain struck him in the chest, the first time it had ever done so. The entire week of his stay, my family and I were dumbfounded at the cardiac doctors' coarseness, unprofessionalism, unavailability, lack of communication skills and patronization. My mother has spent time in [other] hospitals for surgeries and procedures, and her doctors had always been professional and sympathetic. The reason for dad's stay was inherently bad enough, but watching doctors treat our elderly father in such a harsh, uncaring manner all week (when they got around to seeing him at all) doubled our stress.

A sample of the interactive's topics

My sister and I couldn't help but wonder if his treatment had to do with the fact dad is a Medicare patient. We could have been wrong. We have no proof. But hospitals and doctors are reimbursed for only a fraction of their trouble when caring for Medicare patients, and we agreed it at least was a possibility. Toward the end of his stay, we were trying to get dad an appointment with his primary care physician. He'd had a Dr. Brandy Robinson (no relation) chosen as his PCP for quite some time, but he hadn't gone to see her yet. I called to make an appointment — and they wouldn't see him because they're not taking any new Medicare patients. I was reminded of a story I recently read about more and more doctors not taking Medicare patients because the government simply can't keep up with doctors' costs. I thought to myself, The profit motive of health care is rotting its soul.

Then today I clicked around through's fabulous Health Care Conversations interactive. You click a specific health care topic (i.e. Medicare and the Elderly, Illegal Immigrants) to get to a conversation-starter question, then you include your comments on the question. I chose the health care topic Moral and Spiritual Considerations and scrolled through the comments (click here or play around with the embed, above). Timothy Shaw, M.D., of Madison, Wisconsin, did the best job of describing the connection I feel between my Christian faith and collective health care for all:

Our healthcare system is unjust because patients are discriminated against based on their ability to pay. Even though they attended public tax-payer funded medical and dental schools, some doctors and dentists will not see Medicaid patients or those without health insurance.

Our healthcare system is unjust because doctors and hospitals charge different patients different prices for the same service based on their insurance or employer. A patient without insurance may pay 70% more for the same operation or medical treatment as someone with insurance. If one would go to a gas station and be told that you have to pay $3.40 per gallon of gas but that your neighbor has to only pay $2.00 per gallon because of who you work for – there would be "civil" war.

Our healthcare system is unjust because it pits the doctor's fiduciary and moral obligation to the patient, against the fiscal obligation to the health insurer with whom the doctor has a contract. For example, in the mid 1980's, 32 states passed consumer protection laws, in the form of "drive-by delivery" laws to protect mothers and newborns from being discharged from the hospital by their doctors too soon.

Much of the medical research in our country is supported with public tax money through the National Institute of Health grants. Additionally, public tax money supports the Centers for Disease Control, and the National Library of Medicine; institutions which also supports private for-profit medical/insurance corporations. Although many of the discoveries of medicine were not the work of the American medical/insurance industry, past medical discoveries are used to create profit for our private medical/insurance system. For example, when the Austrian pathologist Karl Landsteiner won the Nobel Peace Prize for his 1901 discovery of the ABO blood groups which made blood transfusions safe, saving billions of lives, he gave his discovery to humanity, not a patent lawyer.

Our hospitals were built by the hard work of all citizens. In the late 1800's Catholic nuns from St. Louis hitched their horses to wagons and rode into the Northwest Territory armed with a mission statement from God and founded our first hospitals. They built these hospitals for all citizens, not just the patients with "good" insurance. Our healthcare system is unjust for the reason that people without health insurance or those who can't get health insurance just as likely had fathers and grandfathers who laid on the sands of Normandy and Iwo Jima, and who themselves or their sons and daughters are serving in the Armed Forces today.

Our health system is unjust because of huge profit taking. Health insurance executives don't worry about going bankrupt from getting sick. Forbes reports that two Healthcare Insurance Corporation CEO's made $121 million and $77 million respectively in the last five years. While the medical / health insurance and pharmaceutical industries make billions in private profits, our citizens are lining up at a county fair in western Kentucky, in neglected health, with their teeth rotting from their heads, just to be cared for at a free medical/dental clinic set up in animal stalls in a barn.

I've often wondered why educated people and our leaders cannot see the injustice of our healthcare system. In a historical context however, it is inconceivable to think that the man who wrote "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness", as he looked out his window he could see his slaves working in his fields.

To right the injustices perpetrated by the British against his countrymen, Thomas Jefferson would write the words which lent justification and strength to his fellow patriots to fight the world's most powerful army and navy. However, Jefferson's quill had not the power to convince his countrymen to right an injustice perpetrated by themselves against another people. This would be a conflagration for another time, another generation.

Let us encourage our congresswomen and men to have the moral courage to pass legislation long overdue, to create equality in health care. They should establish a national healthcare insurance plan as a civil right of American citizenship.

Some say that we don't want a Canadian or British style healthcare system. I say let's make America's healthcare system look like the United States space program compared to Britain's or Canada's! Ours would soar like an eagle!

Thomas Jefferson's last words in the Declaration of Independence now ring out as a living document for us today. "And for the support of this declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our lives, our fortunes and our sacred honor."

My dad isn't so poor that he's having to get care in an animal stall. But like those Western Kentuckians and insurance company CEOs, he's worked hard and paid his taxes. Expectedly, there will be a disparity in the houses they live in and the cars they drive. But as a Christian, I can't view one of their bodies as less valuable than the others. I value my soul too much.

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