The strategic health-care reform not being debated
Posted 8/21/2009 03:01:00 PM
© 2009 by Michael Swickard, Ph.D.
Most Americans in these town-hall meetings are, metaphorically, just waxing deck chairs on the Titanic. They argue health-care tactics while ignoring the profound change in health-care strategy. The unexamined and unchallenged change is from a philosophy of social contract to one of social justice.
When I was born in 1950, health care was predicated on a long-standing social contract we citizens had with our government in which the government’s role was to enhance our lives in both longevity and quality. Government-sponsored medical advances were greeted enthusiastically by Americans.
My cardiologist started in the early 1970s when it was uncommon for heart patients to live robustly past 70. With the advent of new procedures and drugs, patients now live actively past 80. Likewise, there were worldwide celebrations when Polio was defeated and then Smallpox, Measles and Rubella.
Many people are alive today because of that social contract with our government. This increase in longevity, a source of pride, is now at the core of our reform debate.
The social contract also had researchers working on eradicating cancer and heart disease; however, the prospect of the changing health-care strategy brings that into this question: Should society be curing cancer and heart disease, since that results in people living longer? This extends the society’s obligations to these survivors for medical treatments and Social Security. That is the reform strategy not being debated.
Instead, there are long-winded debates about the minutia of what is on page 420 of a bill that has multiple versions. Americans are standing on a whale fishing for minnows.
A radical change in philosophy
The health care reform is not about saving money for consumers of health care, and it is not about whether citizens use the private option or non-profit co-ops. Rather, it is the supposition that the government should change how it uses health-care resources based upon a radical change of philosophy similar to the progressive health-care changes in Europe and Canada.
The new philosophy is social justice which, operationally, never takes from the young to give to the old. Under a social-contract philosophy, our government provides resources so citizens live longer and better. Social-justice philosophy says to oldsters, “You have lived long enough; we cannot expend resources on you that could go to the young.”
Other countries have made that change. It is the core of health-care decisions in England. Their health-care motto is: In with the young, out with the old. It is like some strange New Year’s Eve party where the elderly are shuffled off to the cemetery for the good of the country.
If America adopts a social justice philosophy, that changes who gets government-controlled health care resources. Countries making this switch experience unreasonable delays or outright prohibition of resources for people considered too old or of not enough use to the society as a whole.
Social justice says the collective good of the society trumps individual benefits. As a cancer survivor I regularly see the effect of my having had cancer on the current health-care system that endeavors to hold me at arm’s length. But I see even worse outcomes if our country adopts the new social-justice yardstick, which will reason that keeping me alive is good money after bad, since I could re-acquire cancer at any time, thereby wasting money that might go to the young.
So it will be out to the trash heap for me.
Missing the strategic change
Further, the new social-justice government will view my survival of cancer differently from the government of social contract. Surviving my bout with cancer required quick action on a five-hour operation and follow-up radiation. The government that sponsored the research leading to procedures that were successful in my survival was happy. However, a social-justice society would not be happy and would say, “Shuckins, if he had died we would not owe him any Social Security. Hope he dies before we have to pay him anything, despite his 40 years of paying into Social Security.”
The town-hall debaters do not see the beast in belly. They think this a political rather than ethical issue that is a battle over which political party wins. Like the rest of our country, they will be quite surprised by the extent of the governmental betrayal.
With no scrutiny by the media or citizen debate, the congressional leadership and President Obama are set to install this new philosophy of social justice, which will remake us into a New Order Progressive Nation. They are enabled when citizens and the media miss the strategic change and only debate tactics.
We need not debate private options if our government no longer supports longevity and quality of life for older Americans. Those details do not matter in the least if our leaders, using social-justice reasoning, betray and then discard older citizens.