Political Comedy and Health Care

Between Hillobama (my wife says it should be Baralinton now) and accusations that Senator McCain is a skirt-chaser, all I can say is that I have always been proud of my adoptive country. If we are still talking about being ready for a woman or a black person in the White House, then we're not ready. Unless it's Condi Rice. Hey, I'd vote for a Phillipino, as long as nobody asked if we were ready for an Asian-American.

But the polarized political discourse is not so funny, nor is it something to be proud about.

Ya, I'm back to reminding readers that political centrism is a good way to avoid the extremes of either side. Obama's rhetoric sounds like we'll just give everything to the poor and working class of this country because rich people should have no influence or say on how their tax money is used. Conservative talk-radio will pillory all candidates because their positions are not sufficiently selfish, which is the real word for American Conservatism. It's not conservative at all, it's just plain hypocrisy.

So I find myself in a truly awkward position. I work for a publicly subsidized facility which has as its mission the care of poor and vulnerable populations, but I am opposed to the very notion that guarantees everyone such health care.

The crux of the matter revolves around the nature of human rights as they relate to health. Our constitution guarantees a right to life, liberty and the pursuit of happiness. The wording is careful, apparently not to guarantee that anyone has the right to a life without misfortune. By the same logic, no one can reasonably expect a right to health. In fact, health itself is best recognized as a gift, at least as precious as life itself.

Wikipedia gives us a brief lesson, reminding us that basic rights include the right to freedom of expression and equality before the law amongst others. There are several philosophical positions that can drive the definition of rights. I can understand a prohibition of actions that impair the well-being of others. But I need to understand how a right can exist where it requires an active intervention by a trained and licensed professional? Can any government force an individual provider to deliver a specific service? If the government cannot mandate that a physician take care of an individual person in a specific circumstance (except in exceptional and dire emergencies) then no encounter can take place. Thus, no health care can occur. Thus, it's not a right.

There are laws to enforce the rule of law to make sure that people cannot unfairly take advantage of others by force or sleight-of-hand. I can understand how people have the right to work and enjoy the fruits of their labor. I can understand that people should feel they have a right to the environment that makes it possible to exercise their full social, economic and cultural rights. But health care (and day care, for that matter) is different. It appears that current plans to expand health care access rely, not on the government creating an environment where national goals can be accomplished, but mandating the delivery of a service and its price.

Nobody can mandate that every child has a right to an MRI if they have a headache. You can't have a bone marrow transplant if the chances of success are less than 5%. It is unreasonable to insist a surgeon do a procedure if the mortality is high, even if the patient wants it. The surgeon still has a say. I have a problem with health care as a right because I don't believe that anyone anywhere has a right to everything at all times. Especially on my tax dime.

There are good social and economic reasons to exercise government muscle and expand access to subsidized health care. Hillobama's new entitlement is not it. McCain's tax credits are not it. We need a well-thought out way to improve primary care access, acknowledge that cost and capacity considerations mean that not all testing, treatment and convenience is possible for all, provide clear targeted coverage for the most important public health issues in the country and allow continuing business opportunities in health care, albeit better regulated than the current special interests' free-for-all.

Awkward.

The right wants to offer nothing. The left wants to raid the pockets of those who create the most value in society (as measured by income, which may not be the best measure of value but is the most practical.) Hillary's plan is expensive and impractical, Obama just sounds like he's gunning for my tax dollar even if his plan doesn't work as well and McCain just doesn't understand it at all.

Just laugh about it. We have the candidates we deserve, primarily because the wing nuts on the right have driven moderates into hiding, as far as I'm concerned. McCain is the best we have on the political spectrum, but his shortcomings are already pretty obvious.