For Professor Fathie's Credentials Please click Here

America's Badge of Honor is Badly Tarnished

As every young American student learns in history class, the "Declaration of Independence" mandated, among other inalienable rights, the right for the "pursuit of happiness." Recently, in response to a pointed query from a journalist, the CEO of one of America's leading HMOs elucidated his view of the questions of rights vis a vis individual healthcare.

"The right to pursue happiness does not imply the right to healthcare. It simply means that individuals have the right to pursue their own happiness. If successful, said happiness will normally include reasonable provisions for good health, but they are a result of that successful pursuit, not the result of a natural right, doled out to just anyone. Healthcare is something people must earn."

This obviously laissez faire, capitalist mode of reasoning might strike some as overtly misanthropic, but it merits some reflection. The political system and the economic system under which the American people live do not always work in synchrony. America is a country founded on natural rights-and capitalism allows individuals to build lives independently and without fear of over-whelming interference by government (in theory, at least). This is one part of the American equation.

Thus, the anonymous CEO in question makes a rather valid point - we were never meant to live in a welfare society where the government or private business provided for the needs of every citizen. Such a utopia remains far from any political system's reach, as the fall of communism, fascism and austere forms of socialism so clearly reveals.

But the flip side of the natural rights questions requires the government to maintain the integrity of society's institutions, such that the individual's rights are not unwittingly swept from under their feet, through negligence, malice or over-sight. That a capitalistic economic model leaves gaping holes in the fabric of society is the very reason we do not exist exclusively in a laissez faire political system. Laws exist to restrain the overzealous expression of natural instincts like greed, deceit and a host of other endemic social ills.

Sometime in the last several years, however, the nation's healthcare system has managed to slip through the institutional system of checks and balances and spiral into perhaps the most embarrassing and critical crisis this country has faced in several years. Market-driven health- care - in which doctors employed by healthcare providers are more interested in their stock options than their patients, in which gag orders are routine, in which patients die outside emergency room doors - is a blight on our society and a mark against government's obligation to preserve and protect its citizenry, if not to encourage the "pursuit of happiness."

That the system deteriorated to such a point that we now face the prospect of a public revolt against healthcare providers, says a great deal about the reduced moral weight of the oath (remember Hippocrates?) we take as physicians. Not that blame should be placed on physicians - rather, that the system discourages, indeed prevents physicians from executing their duties to their fullest professional extent.

We have reached, in no uncertain terms, an ethical crisis. It is difficult not to mention the extreme irony that such a predicament should exist in the world's most affluent and technologically advanced nation. Cruet ironies, one might suggest with a sigh of resignation, have always been a part of life, however unfortunate.

But America's badge of honor has always, in part, been awarded on the basis of America's desire to sustain and improve the human condition, both at home and abroad. Sadly, as the health care crisis so clearly reveals, our badge is badly tarnished.

Fortunately, the national outcry is finally reaching a thunderous level and Nevada is at the vanguard of legislative reform. Both Republicans and Democrats in Congress are now considering new bills that promote a so-called "patient's bill of rights." It will be interesting to see how far these rights can extend before they begin to ruffle the feathers of the wealthy healthcare industry CEOs. Hopefully, for average and less than average Americans without healthcare, they'll extend at least past the emergency room door.

---