Editor’s Note: This article was written in July 2012 but its message continues to be relevant today…..
Recently the Supreme Court upheld the Affordable Health Care Act. You may know it by the name the law’s opponents have repeated so much that the derogative term has entered our common vernacular – “Obamacare”. As we move forward toward this year’s Presidential election, this law will take central stage in the debate.
I want to offer you a view point here that simplifies the debate and hopefully will serve you as you listen to the opinions that are already being bombarded upon us by the media. I do this simplification with the caveat that I am well aware of the complexities of the American health care “system”. For 20 years, I worked in that system and experienced firsthand many of its issues. I liken attempts to adjust health care to squeezing on a balloon—you push in one area and it expands in another. Attempts to cut back on payments to save costs can lead to providers cutting back on providing services which causes access problems. Attempts to offer more people access to health care or enhance health outcomes frequently drive up costs.
At one point in my health career, I traveled around and participated in many programs with Michael Leavitt, former Republican governor of Utah who was at the time Secretary of the Department of Health and Human Services under George W Bush. I really liked Mike and could feel his genuine care and concern for America and Americans.
Leavitt frequently stated that health care in America is not a true system as a real system’s parts work together with one another, even if they are in competition. He liked to use the analogy that cell phone service in America is a system. You could have any carrier for your phone and still call someone on any other phone system. The parts may compete on one level, but they cooperate on another. Although there are parts of American health care that coordinate their services and data, there are way too many ways that they focus on the competitive aspect.
Leavitt sought a healthy balance between competition and cooperation. He realized there was a place for both. Yet, in my opinion, he felt that it was the private marketplace and corporations that needed to provide health care, they just needed to do it in a manner that allowed a degree of appropriate coordination and cooperation. He tried to point out how some sharing of health data would improve health outcomes and lower their costs. He spoke their profit motivated language and he was successful in getting them to buy in.
This point takes me back to my simplification of the debate. No matter what the issue that is being debated around health care, I think you can look behind the speaker’s position and see that at their core they hold one of two basic viewpoints.
One position is that capitalistic free market forces ought to be given free rein to allow humans to work out some kind of moving equilibrium where health care providers (and corporations that own many of them) can offer services at a certain costs and we users of the health care (either directly out of pocket or through our insurance corporations) decide if we want to buy them. At its extreme position, government plays no role in this market exchange decision.
On the other hand, the other basic position is that by nature of us being humans, we have a basic right to receive quality health care regardless of our ability to pay for it. Yes, health care providers should receive a fair payment for their services, but people’s access to such care is too critical for us to leave it up to market forces where corporate influence will always be driven towards maximizing profits. At its extreme position, government should take over health care and provide it as a part of the “commons”, like parks and highways and other important aspects of life that should not be left up to marketplace.
Now, I realize you may be reading those two positions and feel that you come down somewhere in the middle. Most of us do. Most of us think there is a role for the free market in health care, especially in the areas of driving innovation and quality. And, most of us think there is a role for government, especially in the areas of setting standards and creating safety nets for the poor and vulnerable populations. Yet, even though most of us see a role for both the market place and government, I believe that when we get down to making a choice on an issue, the importance we place on one side of the other of seeing health care being simply part of a free market system or seeing it as a basic human right will determine our position.
To see these points in action, one can look at an interview on TV this past week of a conservative Senator and new online campaigns by progressives.
Chris Wallace interviewed Republican Senator Mitch McConnell on Fox News. McConnell went on about the importance of repealing “Obamacare”. When Wallace pressed him repeatedly to answer the question about what the Republicans would do to replace the popular provisions of the Affordable Care Act that provided access to health insurance for 30 million people who currently don’t have it, McConnell was at first evasive and then finally stated “that is not the issue.” To see the full interview, click here. For McConnell and the Republicans, people having access to health care is not a basic right. What is more important is allowing the free market and corporations to drive the “system”. MSNBC progressive TV host Ed Schultz breaks down McConnell’s taking points further in this clip–click here.
On the other hand, proponents of the Affordable Care Act emboldened by the Supreme Court ruling are now making the case for “Medicare for All”–a single payer system which progressives felt should have been the position of Obama’s law from the outset. New web sites have sprung up and forces are pushing this position, especially in California. Click here for an example. To these individuals, what is more important is ensuring that all Americans have access to health care.
Now, I want to make a leap into an even more underlying belief that I think sits behind these two viewpoints. I think there is a more basic worldview at play here. This takes us to the realm of spirituality (even if you don’t consider yourself spiritual).
It is my firm belief that when we humans look out at the world of material affairs, we see it in one of two ways. On the one hand, many of us look at life and believe that we are all physical beings who are separate and apart from one another and therefore in competition with one another for resources. On the other hand, many of us look at life and believe that we are all beings who are connected to one another on some level and therefore are served by cooperating and ensuring the success and well being of everyone.
If we see life at its essence as being separate beings in competition for survival of the fittest, then we see health care as one more thing for which we are competing, along with the accumulation of wealth via our health care businesses. We want access to health care to be a market place decision based on competition.
If we see life as our all being humans having a physical world experience of separation but at our essence we are all part of some kind of unified oneness (be it a spiritual essence or an energetic field or quantum entanglement or whatever), then we ultimately see health care as an important service that is needed to maintain the quality of the experience of all humans. If we are connected, then it is important to me that we all serve to enhance the life of one another. It benefits me for you to be healthy and vice versa.
I think you know where I am on this spectrum. Ultimately, in my humble opinion, humanity is called to evolve to a higher expression where we have used the experience of separation and the tool of competition to move to our greater way of living—knowing that we are united and that we are here to cooperate with each other in love and service.
Health care is a basic right for every person everywhere. No matter what the outcome of the election or what we do with the provisions of the Affordable Care Act, the current debate is ultimately serving us. As we have this discussion, at some point a critical mass of us—now or in the future–will grow in our awareness to see how we are One. In the end, love will prevail.
Check out all of Mark Gilbert’s books—available at Amazon. Click here to visit his Author Page. This includes his recent one Our Spiritual Rights and Responsibilities. In this book, he offers what he suggests are the 5 basic rights we all possess by virtue of our being these spiritual beings on planet Earth — and our 2 responsibilities we all hold in relation to one another! Check it out!