The Health Care Moral Dilemma

Here’s a Health Care Moral Dilemma and Medical Ethics Question:

Uwe Reinhardt exposes the dilemma in his book, Priced Out: The Economic And Ethical Costs Of American Health Care. He starts by posing this question:

As a matter of national policy, and to the extent that a nation’s health system can make it possible, should the child of a poor American family have the same chance of avoiding preventable illness or of being cured from a given illness as does the child of a rich American family?”

T. R. Reid, in his book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Healthcare, asks a similar moral question:

Do we have to buy life or do we have a right to live?

It’s truly a Moral Dilemma. What is the Right thing to do?

We tend to avoid debating these questions, in fear of being labeled “Socialist” if we say YES, or heartless if we say NO. But what we do says more about us than what we say or don’t say. What Democrats have done, for example, is more consistent with the values of health care as an affordable “social good,” while Republican actions are consistent with health care as a commodity service rationed by income class. It’s that clear.

As Reid put it, Every developed country (except America) has decided that healthcare is a right of citizenship and their various universal healthcare systems put patients first. America, by contrast, has decided that the business of healthcare is business. Those of the healthcare industry like their $3.5 trillion annual revenue and have invested in developing powerful political influence.

Steven Brill, author of America’s Bitter Pill, describes the Medical Industrial Complex as including the insurers, hospitals, drug companies, testing companies, and equipment providers, but it also includes the doctors, consultants, administrators, and investors.

Where is that Easy Fix that we were promised?

There is no quick fix to this health care moral dilemma. Our system is fundamentally broken, and tinkering around the edges just won’t cut it. True healthcare reform must start with political will and include knowledge of WHY American Health Care is So Expensive in the first place.

As important as healthcare is to this 2020 election cycle, I think addressing Extreme Inequality has higher priority. That’s because it underlies this and all other issues facing voters. Inequality also offers Democrats an easy-to-explain narrative and gives voters a common enemy to focus their anger against.

Where are the Fiscal Conservatives?

Even if I ignore the health care moral dilemma and just look at the economics, I find it hard to justify Republican positions without blaming the GOP for the corrupting influence of big money in politics – from wealthy special interests funding their campaigns. If they had the courage to take on the medical cartel and support reforms that improve outcomes and cut health spending in half to match what other advanced nations spend, we’d save over $2 trillion/year. That money could then be invested in programs that improve population wellness and workforce productivity, resulting in additional savings.

Don’t they know about the high ROI of public investments in a healthy, skilled, and productive workforce? Don’t they understand the positive impact on corporate profits, tax revenues, GDP, and global competitiveness? It seems that there are no more fiscal conservatives left in the Republican Party, and that’s sad.

Where are the Compassionate Conservatives?

We rarely hear that term any more because it’s now like an oxymoron. How can a Party so passionate about “right to life” be so against gun controls and safe abortions and be so willing to return to the unsafe back-alley ones that took women’s lives before Roe v. Wade?

How can they oppose measures that significantly reduce unwanted pregnancies to begin with, like sex education and contraception? How can they block public funding of prenatal healthcare for low-income women or deny support for the newborn or mother after delivery? How can they justify forcing a teenage rape victim, who was brutally beaten by her attacker, to carry his baby to term and then be forced to raise it on her own? Isn’t that victimizing her all over again?

And how can they oppose sensible gun safety regulation and instead just send “thoughts and prayers,” after every new school shooting? Help me understand why any of that makes sense. Where’s the compassion in the “right to life” movement? Where have all the compassionate conservatives gone? For any still compassionate, it seems they all went over to the Democratic Party.

I share this political rant today because I truly believe that to fix our broken healthcare system, we must fix our politics; and to fix our politics, we must get big money out and address the corrupting power of extreme wealth. I hope you will also read my more-detailed articles, referenced above. And I encourage you buy Reihardt’s book and share your insights below.

ABOUT THE AUTHOR

Wayne Caswell is a retired IBM technologist, futurist, market strategist, consumer advocate, sleep economist, and founding editor of Modern Health Talk. With international leadership experience developing wireless networks, sensors, and smart home technologies, he’s advocated for Big Broadband and fiber-to-the-home while also enjoying success lobbying for consumers. He considers himself independent, but leans left to support progressive policies. (contact & BIO)