Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill.
Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of ‘safety net’. Dr. Paul held to his consistent position advocating for individual rights, individual responsibility, and less government. I found myself thinking of the old fable about the Grasshopper and the Ant. The thought occurred to me, is meeting our basic needs a right?
I’ve heard the question posed, is healthcare a right? On the surface, I am inclined to think everyone is entitled to healthcare. As it is in America, even without paying and without insurance, everyone can get his or her most basic or emergent healthcare needs met. Mr. Mathews pointed out that a person without insurance still gets an ambulance ride to the nearest hospital if they need it. Dr. Paul raised the question of who has to pay for the healthcare, questioning the morality of forcing someone else to pay for another person’s healthcare, and the morality of not paying for your own healthcare.
On the one hand, Mr. Mathews argued it was a societal imperative to take care of everyone. On the other hand, Dr. Paul argued it was an individual imperative to take care of one’s self, but if one could not, then rather than force others to pay the costs, they could appeal to charities, friends, neighbors, family, and churches. Probably both arguments have merit, and the answer is somewhere in the middle. I am glad I don’t have to decide for everyone! As a physician, I choose to give away charity care and advice daily. But I am not forced to do so, yet. It is my choice to whom I give free care, and to what extent and in whatever manner I feel is medically appropriate for the one getting the free care. I am happy to do it; that’s why I went to school. It is fun and rewarding, because it is my choice.
I don’t see anything stopping Medicare from cutting my reimbursement 21.5% again next month. I have a lot of Medicare patients, and I feel an obligation to take care of them, regardless of how much Medicare pays. It’s not the patient’s fault. But that puts me into a role of serfdom, doesn’t it? Is that moral? And the costs could prove a mortal blow to a lot of physicians’ offices.
What about food? It’s a human necessity. If someone is a little bit short, is the grocery store morally obligated to give away food? How long would the grocery store stay in business? I don’t remember what happened at the end of the Grasshopper fable. I bet some Ants told the Grasshopper to get lost. Some no doubt would share from their hard earned food supply. Should all Ants be forced to share or should they have a choice?
Patrick W. Hisel is a family physician.
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