Changing Attitudes towards Healthcare

The country is in the grip of a healthcare debate that is split unfortunately along party lines. No matter what changes are made, there are certain attitudinal changes that the population has to make or we’ll be worse off than before.

Before all that, there is one question for which I cannot find a good answer.

Is healthcare a privilege or a right?

There is nothing in the constitution about that. Now in the Declaration of Independence, we read:

“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.”

That is the closest we come to healthcare being a right. Now prisoners have it good – they receive free healthcare because it is seen as an obligation of the state to them!

If the constitution does not guarantee it, then any argument for or against is just that – an argument!

Congress must then decide whether to pass this as a law or not. If healthcare is a right, all efforts must be made by the government and businesses to ensure that all have adequate access to healthcare. If it is a privilege, that totally changes the stakes. Then, anything the government or businesses want to do is subject to good will and policy.

My feeling is whereas a majority of liberals see healthcare as a right, many conservatives and libertarians see it as a privilege!

As I said earlier, regardless of what happens, the population needs a huge attitudinal change to make any form of healthcare policy work.

1. Prevention is better than cure.

This is an old saying and it has stood the test of time. Yearly checkups, mammograms, staying active, eating healthy are little things that go a long way to keep one healthy and prevent that severe illness and fat bill from the surgeon! It seems to be an anathema these days. It’s get sick, then rush to the ER! Even people with good health insurance are guilty of this. Whatever type of policy is decided on, it should mandate yearly visits to a physician and quarterly visits to a dentist! Europeans tend to be healthier for several reasons – one is the fact that they have very good preventive healthcare.

2. Each is responsible for his/her health.

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Just as I am responsible for my car’s upkeep, so am I responsible for my body, mind and soul. If my car’s engine burns out  because I forgot to fill it with oil, I cannot blame my mechanic if he can’t fix it. The repair is usually so expensive, most people don’t consider replacing the engine. On the other hand, if one eats uncontrollably, drinks and smokes and ends up in the hospital with heart failure, the expectation is that the doctors should fix him to be as good as new! Consider a scenario where each citizen controlled his/her own healthcare dollars. You paid for every procedure, visit, test etc or you bought the insurance to pay for these services. It would make people  more cognizant of the cost of not taking good care of themselves. I believe there should be an added cost for being obese, for smoking  and/or drinking and for not getting yearly checkups. If a young man decides to go riding his motorcycle even though his blood alcohol level is in the stratosphere, any care he subsequently receives after he wrecks his bike should come out of his pocket. In short, be responsible for your health.

3. Don’t forget the baseline.

We live in the age of Viagra, where sex is possible for the older generation. Age does not seem to be much of a hindrance anymore. In 2007 a 60-year-old woman delivered twins in New Jersey. Last year, a 59-year-old delivered triplets in France! We keep pushing the limit. It is no surprise that patients expect nothing short of miracles when they show up in the hospital. Expectations are so high that, it is not uncommon that both doctors and patients seem to forget the baseline. A diabetic who has  uncontrolled blood glucose for years is not going escape unscathed. If he/she shows up with a gangrenous foot, that limb has to be amputated and their mobility is going to be compromised. This reduces physical activity and increases the already high chances for morbidity. Don’t forget the baseline!  It is sad to loose patients to cancer but terminal cancer is in most cases, well, terminal. Heroics just lead to even greater disappointment and pain. Don’t forget the baseline!

4. Let there be Dignity in Death.

Maybe it’s cultural, maybe it’s the wish not to loose a loved one but millions of dollars are spent every year in the care of patients who should have been left alone to die in dignity. It may be that the patient is too old and frail to survive a surgical procedure or that a particular test won’t add anything to the attempts to save a loved one. Time and time again, family members insist on having everything done. They are not alone in this. Physicians are apt to give them false hope. There is the need among some doctors,  to look like the knight in shinning armor who swooped in and saved the day. Then is the small matter of litigation attorneys who circle like buzzards. It is much more dignified to let a death occur with family members (after the requisite goodbyes) than alone in some hospital room with the body flayed open and expectations crushed! I agree, death can strike anytime but if one has the chance to prepare for it, isn’t that a bonus for the family and loved ones? Lets accept death when it’s inevitable  – we’ll afford family members and patients dying in dignity and save countless healthcare dollars.

Healthcare resources are not infinite. Lets use what we have wisely!