When did medicine become politics? This week, the Supreme Court heard arguments for and against the health care bill and political commentary surged. One way to understand the debate is understand our mixed feelings about health care in general.
In Europe, health care is considered a human right. The government funds health care for all because it is a right, not a privilege. The government is responsible for maintaining individual health, but the government is also responsible for the health of society. Since financial and resources are limited, government decides on which individuals get what health services and when they get services. The government also pays for medical school, so it controls how many students are accepted, how many specialists will be trained, and where the physicians will train and work.
In the United States, things are not so clear. Most believe strongly in the American ideal of individualism, so we believe that every individual should have unlimited access to the best health care the world has to offer. Since we favor individual rights over societal rights, we are very resistant to the idea of “socialist medicine” in the European model with governmental limitations on access to health care. However, we are also realists and understand logically that we do not have unlimited resources in the private sector. So how do we reconcile the idea of unlimited resources for all with no government involvement? Therein lies the conflict.
It seems that the current debate on health care ignores the fundamental question – is health care a human right? If it is a human right, then we must make difficult decisions about how government can ensure this basic right for all without draining our limited societal resources. If it is not a human right, then we must discuss who should have access to what kind of health care, and what role the government should have in making these decisions. In any case, it appears that politicians, not health care providers, are going to determine the future of medicine in the United States.
Live Mentally Healthy,
Cognitive Psychiatry of Chapel Hill