Is health care really an inalienable right?
On Easter morning 5 a.m., my wife’s appendix burst while waiting for care in the emergency room of one of the world’s great university hospitals. I’d brought her in at midnight to a full waiting room pacified by the flat-screened omnipresence of Jim Carrey playing God’s assistant in Bruce Almighty. “Oh, God, the pain feels like a stabbing from the inside,” groaned my wife to the triage nurse. But the obvious pain didn’t trump the external stab wounds of several young men who had leapfrogged the queue into the ER. Two hours later, we were still waiting to be admitted.
The doctors knew at least one of the recreational stabbing victims by name. Apparently, the kid was a Saturday night regular. So was the elderly looking young woman who came in with unbearable pain each time she stopped drinking for longer than a day. Further symptomatic of the ER’s illness was a teen who showed up just for a good night’s sleep. (She refused to wake up for treatment of her bellyache).
Once we were admitted, the physician’s attention was diverted by two more trauma room alarms and other assorted situations, including a visitor raising living hell because she was missing breakfast. One of the stab victims was regaling his girlfriends with tall tales filled with too many expletives to be deleted here.
I’m not complaining. The young nurses were saints in a sedated hell that in its 50/50 split between horror and boredom did seem like an eternity. The staff was clearly doing its best, buying time by dispensing painkillers and gentle words. But the emergency room was in fact more like a second waiting room — a traffic jam with lines every step of the way for ultra sounds, X-rays, CAT scans, more analysis, more diagnosis and scheduling.
Just when we thought the wait was over, the legal process kicked in: Three separate surgeons were required to conduct three identical interviews. The hospital, after all, has to look after itself. And while it did, another hour vanished. By the time we rolled out of the ER, it was nine in the morning. Sometime between the CAT scan and surgery, my wife’s appendix had ruptured and poisons were spreading inside her.
Despite the current debate, U.S. emergency departments have been treating health care as an inalienable right for quite some time now, distributing it on an as-needed basis and quite inefficiently largely for free. It’s been available to the worthy and unworthy non-paying poor. At what other time in history has there been such largesse?
Many of the people ahead of my wife would not have needed the emergency room if they behaved more responsibly — and that’s the real issue for this country as we begin to distribute health care outside of the ER. Will this arrangement be fair to the people who pay for healthcare and don’t abuse their bodies? Will the responsible majority become a minority? And if so, will health care as we know it — or wish it — remain economically sustainable?
Does reform have any chance at solvency if too few people see themselves as their own best primary healthcare providers? If health care is in fact a right, has a violent, litigious nation that smokes too much, exercises too little, and is in debt up to its ears earned the right? If so, can we afford it?
The Founding Fathers never promised happiness — just the pursuit of it. Ditto for health care. Folks in this country from now on had better work a little harder at caring for themselves. If health care is to make it out of the ER alive, we all have to do a lot more pursuing and a lot less suing; more taking care of ourselves and less taking care for ourselves; more ensuring that small and large organizations have equal insurance rates and less talk about equal rights. Remember, we’re all co-payers now that health care is perceived to be a right. But you still have to earn the right — by, at the very least, first doing no harm.
