At least 18,000 Americans die each year from lack of healthcare coverage. My sonâ€™s cancer is an illustration. A medical doctor, he contracted mylodysplasia, a life threatening blood cancer. To live he needed a bone marrow transplant. The treatment has a 50% mortality rate, sure sterilization, and prohibitive cost. Neither cure nor normal life expectancy is guaranteed. Still the chance to extend his life and medical service could have been his reward.
My sonâ€™s insurance did not cover the search for a compatible donor. The Financial Director of a famous cancer clinic called to ask, â€śWhat can you contribute to initiate the search?â€ť With my sonâ€™s life at stake my wife said we could manage $5,000. We are senior citizens living on a fixed income. Later I called for clarification, â€śWhat happens if we couldnâ€™t afford anything? A long pause. Finally she said, â€śYou must make arrangements to pay in fullâ€ť. â€śAnd if we canâ€™t, what happens?â€ť The financial director hesitated. She didnâ€™t want to say that no donor search would be initiated and that my son would die... but her hesitation said it for her. Her philosophy was clear. She wore the blinders of her culture. She worked for a for- profit clinic that believed in the bottom line. She believed in that policy herself. It was the only thing she knew. How could she understand the concept of â€śHealthcare as a right regardless of ability to payâ€ť? Yet this is the ethical gold standard of every industrialized nation with the sole exception of the U.S. Her mind could not process that the health outcomes in other nations are superior and the cost half to two thirds less.
Another illustration is the case of a child born three months early. The cost of incubator care and treatment while the lungs and heart developed was $ 500,000. I asked the mother, â€śHow did you pay for it? â€ś She replied, â€ťFortunately, we qualified for Medicaid.â€ť I asked, â€śWhat would have happened without Medicaid? â€ť She replied, â€śIt would have been a choice of letting her die or going bankrupt.â€ť Without Medicaid she would have joined the legions of other Americans whose lives have been diminished forever by bankruptcy.
Who will break the unspoken American cultural ethos, â€ś You deserve to die or be ruined if you canâ€™t afford to payâ€ť? What will it take to break the ethos that itâ€™s OK to expect weakened persons to spend most of their time writing letters, e-mails and telephone calls to insurance companies intent on delaying and rejecting valid claims resulting in wrongful death. These tasks would be daunting for a person in good health, yet for a sick person the ethos is , â€śFill out the forms or you deserve to die.â€ť
The Greek philosopher,Socrates said, â€śCharacter is destiny.â€ť With regards to healthcare I wonder how he would have compared the character of Americans relative to that of other nations... who have opted for universal health care as a birthright? Nobel Laureate Harold Pinter wrote, â€ś What has happened to our moral sensibility? Did we ever have any? Is all this dead?â€ť
Medical doctors with life threatening cancer fare no better. The same ethos prevails. â€śIf you canâ€™t pay you deserve to dieâ€ť. The Hippocratic Oath no longer holds. Physicians, it appears, also wear cultural blinders. Their allegiance, it appears, is to words not actions.
Health care reform requires moral commitment. It is an ethical issue. The cruel seemingly impenetrable cultural bubble needs to be broken to let in the fresh air essential to maintaining the values we say we hold dear. Our certainty that our present highest cost in the world privately run medical/ insurance industry is â€śthe best in the worldâ€ť must reach the point of cognitive dissonance. This false assumption must be replaced by the truth... so called socialized medicine (single payer) as practiced in every other industrialized nation makes a stronger and healthier nation .