Is Health Care A 'Right'?
By Harris R. Sherline
December 29, 2008
Here's a hypothetical: Someone close to you has a very serious illness, diagnosed as terminal, say cancer, and the doctors are recommending aggressive treatment with chemo-therapy or radiology, or major surgery, or some combination thereof. What should they do?
On the surface, the answer may seem obvious: get the treatment, of course.
But, what if it produces extremely harsh side effects that are so debilitating the patient is barely able to function for weeks or months. And, although the treatment may buy the patient some time, perhaps a few months or a year, it is clear that the he or she will not live much longer. Add to the equation the fact that the care will cost $200,000 or $300,000, perhaps much more.
Does this patient, or any patient for that matter, have an absolute "right" to treatment (health care) regardless of prognosis or cost? How do we decide? And, who should make the decision? The family members, the doctor or the hospital or the rules of the health care system?
These are never easy decisions, and they are complicated by an overlay of personal factors. I have seen families confronted with such situations reach the point of open conflict over whether or not to "pull the plug." It can be a gut wrenching decision, often involving deep seated feelings about a parent, a spouse or perhaps a child. In 1998, the highly publicized Terry Schiavo case thrust this issue into the public domain at the time. She was diagnosed as being in a "persistent vegetative state," and the argument between her former husband and her parents made headlines for weeks.
The issue is further complicated by cost considerations, which is where those societies that have socialized or nationalized health care plans encounter problems: They can't afford extraordinary health care costs for many elderly or gravely ill patients. As a result, health care is rationed, denying it to certain classes of patients, such as those who may be extremely obese, or smokers, or who may have an incurable disease or condition.
In 1901, average life expectancy in the U.S. was approximately 49 years. Over the last 100 years, it has dramatically increased to 77.9 years. This provides testimony to the advances in health care that have been made, but costs have escalated along with longevity.
If health care is a "right," should there be a limit? If so, what should it be? Is it possible to provide all the health care that everyone needs or wants on an open-ended basis? With the Medicare and Medicaid programs already operating at a substantial deficit, where will the money come from to further expand the scope of the coverage? The Peter G. Peterson Foundation has reported that if the federal government stopped the Medicare program tomorrow -- collecting no more payroll taxes and allowing no further accrual of benefits -- it would still owe about $34 trillion to those people who are already entitled to health care benefits.
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