Tuesday, June 27, 2017

Is Healthcare a Right or Privilege? Wrong Question.

The question comes up all the time: Is healthcare a right or a privilege? Pope Francis has even weighed in.

I don't think this is the right question.

When people ask whether healthcare is a right or privilege, they are basically asking whether healthcare is either an act of charity or a luxury. And then if it is an act of charity, they ask whether others are entitled to that charity or not. Furthermore, this question implies that the benefits of healthcare go directly to individuals and not to society as a whole.

Sometimes the questions we ask have more power than the answers. A question can frame the debate and imply assumptions about the topic. Without realizing it, most of us answer the question only within the categories that the question gives. The way questions are asked can exert a powerful control over us if we are not aware.

Once asked, the discussion quickly gets derailed in debating the nature of charity itself and whether anyone is entitled to it. These are hot-button issues in US culture that usually promise nothing but gridlock.

I'll use an event from my life to illustrate another way to look at this issue.

My Story

Several years ago, I helped establish the Columbus Catholic Worker (CCW), a center for charity and justice efforts. It was a wonderful experience feeding the hungry, providing clothing to the less fortunate, teaching ESL and offering hospitality to immigrants. Ministry was blossoming in a part of town that was thirsty for Christian love in action. The organization was growing and putting down roots. While it took a village to birth these efforts, the CCW eventually fell under my care and direction. I loved it and felt God's grace pulsing through it.

Today, the doors to this organization are closed. A multitude of reasons converged to bring it to that point, but an often unnamed reason lurking in the background was healthcare. Because of a cancer diagnosis, I needed a "regular" job that came with health coverage. It might have taken several years before the CCW could have grown large enough to offer a salary with health benefits, if ever. I was okay with that. I could live lean for a while. I could wade through and wait out other problems. But I could not wait for health coverage. This organization could have served all of Columbus for many years. It was already having a positive impact on many people. It could have been my life's work. It took a lot of effort from a lot of people to start it, and it's not something that can be re-started so easily. It was hard to walk away from it. 

While I have no regrets about where my life is today, this story illustrates an important point:

I am a citizen who had ideas and energy. I was willing to try out new ideas and take risks. The same could be said of my friends and partners who worked beside me in this ministry. The CCW benefited not just me but dozens of individuals and (dare I say) the whole city. But this work is no longer being done. 

Just imagine how many other people have to scale back--people with ideas, new inventions, innovations and business ideas. They have to limit how much they share these gifts because they are squandering their time and energy securing health coverage. 

We all suffer when we make it difficult for our neighbors to share their gifts.

Americans often live in a Hollywood fantasy that celebrates--and even expects--that others overcome every bit of adversity and still come out on top. After all, it happens in the movies and sometimes in the history books. It does work for some people, and those people deserve to be celebrated. The problem with those stories is that they don't reflect a fair expectation. In real life, real obstacles take a real toll on real people. It's not because people don't have the character, skills or faith to overcome them. Rather, it's just simple math: Someone who runs with a 50 lb weight strapped to his back is not going to run as far or as fast as if he did not have that weight. Yes, the weight may build extra strength and character and force innovation, but it may also come with significant delays, setbacks and failures in the meantime. If someone has a great business idea, I would rather she begin when  she is 25 years old rather than 45. She will bring more wisdom at age 45, but she will also lose 20 years of experience during which she could have been refining her craft rather than working side jobs in an unrelated field.

Everyone loves a good story where people pull themselves up by the bootstraps, fight all the monsters and win.  But it is pure insanity to make the lives of our neighbors as difficult as possible as a game to see who is able to turn that into a heroic quest and win. We are all too quick to assume that if a business venture fails, that it "wasn't meant to be" or that the people just did not work hard enough or have a good enough idea. It could simply be that an environment that is unfriendly to new ideas and ventures is going to result in, well . . . fewer ideas and ventures.

In this country, we are shooting ourselves in the foot. People get angry because a dime of their tax money might benefit someone else. What they don't realize is that when their neighbors are better off, so are they. It's a safer, healthier, smarter, more advanced country we are building. It is a more competitive nation in the world market. Consider my story and multiply it by a thousand. Think of all the businesses, church ministry efforts, nonprofit organizations and other new ventures that are not happening because people either need to either get health coverage or are crippled under medical debt.

If I want to start a business, I don't have to go out and cut trees down to build a road to transport my goods and services. I don't have to build water or sewer lines. I don't have to train employees in basic math, reading or problem solving skills, because we have public education. The only thing missing is that I can't expect the people I hire are healthy enough to work. It is one glaring piece that is missing.

Universal health care means that our country can be more competitive as people take less time off work due to illness, that communicable diseases are treated before they can spread, and that a major obstacle is removed for my fellow citizens who want the space to innovate. 

To me, it's not a "right" or a "privilege" that I can leave my house and take my car on any road I want. I don't think you are mooching off the government because you drive on the freeway or public city roads. It's just common sense that roads are open and available to all, including businesses. I don't spend any time at all upset that my tax dollars might pay for a road to a remote town in Montana or California that I myself will probably never use. For the same reason, I would not be upset at all that my tax dollars would pay for my neighbors to get the healthcare they need to stay alive, healthy and productive (in that order).

It would be so complicated if roads were only for certain people. Imagine if you bought a "road plan' where you could only use certain roads and had to drive extra miles across the city to use the roads in your "plan." Yet we do that with our complicated medical plans that exclude us from so much.

Charity is great. I wish we could make the decision on healthcare based solely on humanitarian reasons and not take into account whether it makes our neighbor more productive. But this is not going to melt the ice in this discussion in this country. Whether healthcare is a right or privilege is not the only question when we go to the voting booth. Providing universal healthcare is simply what a smart country does that wants to stay competitive and advance as a civilization. Like public roads and public education, it provides a basic infrastructure so that we can all share our God-given gifts more broadly and without reservation. It's the next logical step in the growth of a healthy society.


  1. Excellent points to ponder and hopefully change the entire conversation about our healthcare system.

    1. Congress knows that it wouldn't make sense to provide anything more than emergency room services to our poor, just to dump them back on the streets. The deprivation of basic food and shelter, along with the profound stresses involved, take a very heavy toll on human health. In fact, the overall life expectancy of the US poor already fell below that of every developed nation.