#59 – Dick Bernard: Should there be Health Care for all? A simple exercise.

This is post #3 of 13: the others are July 24, 26, 29, 30, 31, August 1, 2,5,6,7,10,15.
Posts #58 and #56 (July 26 and 24, 2009) are also on the Health Care Reform issue; Post #60 (not yet begun) will be on Health Care and the Middle Class conundrum; and #61 on Nursing Home and Long Term Care.  I’m not an “expert” in this area (I doubt even the “experts” are, but I know quite a bit from work and life experience.) 
What started out as a simple idea has become more complicated than I thought, but the simple exercise, below, might help individuals begin to get an idea of the complexity of health care systems in this country, how a simple system can become bewildering – a system promoting individual disasters. 
Take a single sheet of paper, crease it down the middle, making two columns.
In the first column make a list of everyone you know in your own family, among friends, colleagues, their families, etc., who in one way or another cannot economically navigate by themselves.  This could include people with serious mental, physical or emotional handicaps; people in jobs without adequate insurance, or those who might be laid off from such jobs and be without insurance for short or long terms, ETC.  (There are many et ceteras.)
In the second column, make a similar list of everyone you know personally who is “wealthy”.  For purpose of discussion, this could be anyone who could financially survive a catastrophic medical event even if uninsured. 
There could be a third column – the big majority of us, with all the unusual arrangements which make up our own health care – but the first two are good to illustrate how our system works (or doesn’t).   #60 will speak directly to the Middle Class insurance problem. 
My first column is quite lengthy, even though I come from a family that values hard work and self-reliance and would be considered middle class, and is white.   I can ask myself, and I ask you as well: “which of the folks on the first list should be set adrift, to ‘sink or swim’ on their ownIf they die, tough.  Don’t send me the bill.”  Most of the people on my personal list already receive one public benefit or another, as they do in all families, including a very large number on Medicare. The often-reviled Medicare law of 1965 assured that: when you turn 65, as I have, you’re on Medicare – no choices.  But also on my list, and probably on everyone elses, are some people now in the “middle class”, who very well may find themselves, their kids or grandkids in crisis down the road, marooned outside the health care system.  If health care for all is a gravy train, as some may suggest, who do we throw off of it?  Do we solve the problem by getting rid of Medicare and Medicaid?  These are not simple questions.  (More on Medicare history at http://encarta.msn.com/encyclopedia_761568111/Medicare_and_Medicaid.html)
My second column includes a single name.  He was a very wealthy businessman, and almost 50 years ago was a governor of my state, and before that a respected state legislator.  He developed his small company into a Fortune 500 International Corporation.   He and I came to be very good friends.  He died in 2004.  It was a great personal gift to get to know him.  Most of us don’t even know a single truly wealthy person.  Not all of them fit the caricature. 
I could go on at great length about the people in my first list.  My “Exhibit A” is the relative who was caught on a home movie at a large family reunion 16 years ago.  I looked at this home movie just a week ago.  This person, who appears on screen by herself for only a few seconds, was an adult, and she was clearly cowering in the corner of a building, most likely terrified by the throng at the festive gathering.  I didn’t know of her then, but later learned that she was chronically and quite severely mentally ill and simply could not function in “normal” society.   So far as I know, she is no different today.  She lives at home; most certainly she receives public assistance, as she should.
Each of the others on the my list – and yours – have their own stories, some possibly self-inflicted (as chemical abuse); most through bad luck or no fault of their own. 
My points about these lists – and yours – are these: 
1)  Every one of us, if honest, can make similar lists of people in our own circles.  Every one in our society could.  These folks are part of humanity, deserving of treatment for their ailment, and care beyond minimal needs.  They exist everywhere in our country, no less than around the world.  They just happen to have dis-abilities.
2)  That single wealthy guy on my list?  He was no pariah, worthy of scorn.  He has important public buildings named after him.   Were he around to engage in this health care debate, it would probably be a no-brainer for him: if it is for the good of society then everyone should be covered, he would probably say, today.  He spent a good part of his young life as an orphan, and he understood what it was like to be under-privileged.  In his public policy days, group insurance was basically unknown, but medical care was also very inexpensive.   He’d probably say, “let’s figure out how to get this problem solved”.
3)  Probably the real dilemma comes for the folks in the middle – the vast majority of us.  Some of us have insurance, some don’t, some pay more, some less, for better or worse coverage.  We deal with great uncertainty, and it is in our interest to get some consistency for all. #60, on July 28, will deal with this issue.       
4)  To those who say “this is all well and good, but don’t expect me to pay for illegal aliens” or, “we can’t afford this”, or “fill in the blank” pet exclusions to universal care, a simple thought: we are in a global world, and among the problems we face is that communicable disease does not stop at state lines, or town boundaries, nor country borders.  Wouldn’t it at least make sense to take care of the basic care for all, since it would lower the odds of that killer disease reaching our doorstep?  And shouldn’t health care, like education, be a basic human right for all of us?  It is, after all, in our own selfish interest.