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Health Care and Justice

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Sep 04, 2009 by Dieumeme Noelliste | 0 Comments

During the past several weeks, the healthcare debate has been raging like a mighty hurricane. Like an intense and fast moving storm it has caused agitations of all sort. It has awakened ideological passions and brought into sharp focus partisan differences on the role of government in public life. It has reactivated the nest of self interests and stirred up latent political instincts. It has occasioned a loud reassertion of the society’s penchant for an individualistic outlook on life and its confidence in the strength of the American way of life.

The reaction evoked by the debate is telling. For one thing it shows that for Americans, health care is a matter of utmost concern and greatest importance. It is clearly evident that for people on all sides of the argument, the issue is a deeply personal one, touching to  the very core of their being. Further, the response demonstrates that we are dealing with an enormously complex issue which is not likely to be satisfactorily resolved by the adoption of simplistic measures. That’s is why it is, to my mind, wise and prudent that sufficient time and thought be devoted to the crafting of a system that pays careful attention to all the concerns voiced by the citizenry. Something so critical to our collective well-being should not be approached in a lopsided fashion. As difficult as it may be, we must do our best to rise above self interest so the common good may be served. The health care crisis confronts us with the challenge and the opportunity to demonstrate genuine altruism and real concern for community. It provides us an occasion to show that we are our brother’s keeper, and that, as a society, we are capable of practicing collective compassion.

Clearly, the adoption of such a high moral ground demands hard work on various fronts. One does not transcend self interest effortlessly. First, it requires the willingness to engage in a conversation that  places high premium on patient listening, wholesome speech, mutual respect and civil deportment. Because none of us has a monopoly on wisdom, everyone must be given the opportunity to share, without inhibition of any sort, the little bit that we do possess. The task at hand needs this. To deny any voice the right to be heard is to potentially weaken the outcome of the process by depriving it of an important input.

Secondly, the stance being advocated here demands an openness to the truth. Truth is a critical, load-bearing pillar in the construction of any lasting edifice. For the good of the process it should be welcomed and received regardless of its provenance: the left or the right. As tempting as it may be, ideological commitments and short term gains must not be allowed to lead us to falsify facts, misrepresent positions, and invent myths. The stakes are too high, and the implications too far reaching for such a gamble. It matters not how noble the cause and how strongly we adhere to it, defending it through the employment of false means is not an option for any society which strives to be virtuous. In the pursuit of virtue, falseshood must always be persona non grata.

Thirdly (and closely related to the truth question) is the importance  of humility for the success of this enormous undertaking. There is no question that the solution we are seeking must be an American one. At this stage of our development it would be foolish to think that all we have been doing in the area of health care is wrong, and that there is nothing worth preserving. Nor is it possible to suppose that we can design a system that does not take into account the peculiarities of our context and our distinctives as a people. But to acknowledge this is not to say that we should not avail ourselves of helpful features that are part of systems in operation in other latitudes, and which are adoptable to our own.

Through the centuries, people the world over have embraced American contributions to a great variety of fields, and have been blessed by American ingenuity. It will not diminish us one bit if we choose to incorporate into our health care system elements which have worked well elsewhere.

But trumping all that I have stated above is the high value that we as a society purport to place on life. There is hardly a more appropriate domain where the seriousness of this claim can be tested and demonstrated than the area of healthcare. If the reform process is guided by the principle of the absolute value of human life, we will not be satisfied with any system that leaves out any number of persons who are part of our society. It matters not  that number is  in the millions, the thousands or the hundreds.Similarly, if human value is a key compass, the question of affordability will not occupy the prime and determinative place that it seems to be accorded in the present debate. It certainly is a critically important question, and it would be foolhardy not to consider it. But where the value of life is a primary concern, affordability cannot be the first issue that is settled. The first and determinative question is the necessity of the undertaking and the commitment to tacking it. The affordability issue occupies center stage when the timing for the implementation of the prior decision is considered.

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