In the October 2, 2017, issue of The New Yorker, in “Is Health Care a Right?” (p. 48), Dr. Atul Gawande reports from his home town of Athens, Ohio, in the Appalachian foothills, where he asks people this question that divides Americans.
He receives answers that have not been widely heard, however—ones that point to potential common ground. Gawande writes, “Before I entered the ﬁeld of public health, where it’s a given that health care is a right and not a privilege, I had grown up steeped in a set of core Midwestern beliefs: that you can’t get something for nothing, and that you should be reluctant to impose on others and, likewise, to be imposed upon.” In a country where pretty much everyone has trash pickup and K-12 schooling for the kids, we’ve been reluctant to establish a basic system of health-care coverage that’s open to all. How much aid and protection a society should provide, given the costs, is ultimately a complex choice for democracies. “Debate often becomes focussed on the scale of the benefits conferred and the costs extracted. Yet the critical question may be how widely shared these benefits and costs are,” Gawande writes.
Liberals often say that conservative voters who oppose government-guaranteed health care and yet support Medicare are either hypocrites or dunces, but almost everyone Gawande spoke to in Athens understood perfectly well what Medicare was and was glad to have it. To them, Medicare was less about a universal right than about a universal agreement on how much we give and how much we get. “Understanding this seems key to breaking the current political impasse. The deal we each get on health care has a profound impact on our lives—on our savings, on our well-being, on our life expectancy. In the American health-care system, however, different people get astonishingly different deals. That disparity is having a corrosive effect on how we view our country, our government, and one another,” Gawande writes.
The prospects and costs for health care in America still vary wildly according to job, state, age, income, marital status, gender, and medical history. Few want the system we have, but many fear losing what we’ve got. We disagree profoundly about where we want to go. And yet we do share a fundamental agreement that we all have lives of equal worth. As Gawande writes, “What we agree on, broadly, is that the rules should apply to everyone. But we’ve yet to put this moral principle into practice. The challenge for any plan is to avoid the political perils of a big, overnight switch that could leave many people with higher costs and lower benefits.” He continues, “We want to reward work, ingenuity, self-reliance. And we want to protect the weak and the vulnerable—not least because, over time, we all become the weak and vulnerable, unable to get by without the help of others. Finding the balance is not a matter of achieving policy perfection; whatever program we devise, some people will put in more and some will take out more. Progress ultimately depends on whether we can build and sustain the belief that collective action genuinely results in collective beneﬁt. No policy will be possible otherwise.” Please see this link: http://bit.ly/2yzX3gb