In Part 2 I lay out a few of my thoughts on the resistance to such a plan.
I begin with a final comment on Part 1: I believe we are going to flounder and deliver suffering to one another until we come to understand – at least better understand – the ‘hardwiring’ that accompanies human consciousness. ALL the hardwiring – no cherry picking allowed. The hardwiring we carry can be cast as a set of Principles. These Principles also merit a capital ‘P’ because they are indeed inalienable. We carry both Noble and ignoble inclinations – each and every one of us. All rooted in hard-wiring. Because health care systems can demonstrate more of either (Noble or ignoble), and because actual physical survival is at stake, this is as good a human concern as any in which to stop and examine the dynamic of Noble Principle and ignoble inclination operating within every human psyche.
Perhaps the above paragraph is a good transition into my effort to understand resistance to an American Public Health Care Plan, one that ignores inclination to profit.
I ask myself: Given our frequent statements of belief in ancient teachings that guide us toward Compassion/Justice over more mundane concerns, given the obvious economic/monetary efficiency of pooling the entire population so that those in good health can allow their funds to support a health need in another while knowing should need arise for themselves, it will be met – how could anyone using logic and reason possibly object?
What I am going to say here is today’s ‘version’. My efforts to understand result in quite a fluid range of possible conclusions.
Without wanting to seem judgmental, and willing to include myself in what I am going to lay out as observation of human behavior (except, maybe, in this HC debate!?), I think we have to go back to the above Part 2 paragraph that brings up the dynamic between Nobel and ignoble human impulse.
There is ‘something’ far more mysterious about our “being human” (and having human consciousness) then we usually pay attention to in our ordinary thoughts. Here on “Home Base Earth”, we live in complex social structures, with complex economic support structures. It is enough for most of us, most of the time, to steer our lives, our choices, through all this complexity, building some kind of future security for ourselves. This is what “America” is “all about” for many. This is why we are here – why we, or our ancestors, arrived on these shores.
Somehow, despite the reality that some of us, or some of our ancestors***, arrived on these shores for security reasons unrelated to making lots of money, we have come to equate “security” with “monetary accumulation”. Economic systems pretty much demand this of us!
Despite a history that includes lots of cooperative effort among early peoples (not to mention existing peoples, here before we arrived), despite essential rural cooperative movements, labor cooperation to effect reasonable working conditions, citizen cooperation to assure voting rights at several times in our history, cooperation – even a bloody war – to rid our culture of slavery, we have lost sense of what committed cooperative behavior can achieve for ourselves. We have forgotten that human excess will always be with us. We have “rested on our imagined laurels” as if there is nothing to be challenged, as if we have “got it all figured out.”
It is my experience, in conversation with those who decry an American Public Health Care Plan that elects to function without profit motive, that they have come to believe there is a Principle of economics that must be “obeyed” even if some citizens are without insurance, or under-insured, or forced into bankruptcy (and/or become debilitated and/or die.). This point of view seems to believe – I say seems, as none have actually said this – that they “have no choice”. They must stand for this Principle.
Now recall, I have been using a capital ‘P’ for hardwired Principle. I am going to shift this economic principle to a lower case p. I do not believe for one minute, find no evidence for, our economic system being “hardwired”. Making profit on financial matters is a construct that humans have devised, or that has grown out of human economic structures. Economic structure varies across the globe, it is invention, not Principle.
Efficiency may be hardwired, and may be involved in our economic construct – but if it is, then we are brought back to “what is the most efficient means by which we can deliver HC to ourselves? And Efficiency, not ‘profit’ becomes the underlying Principle.
Nevertheless, there is a deep commitment to belief in evils that will befall us if we “let go” our “profit driven economic system” for this specific issue of health care.
“Those without responsibility will allow themselves to physically deteriorate and I’ll have to pay even more.” (This ignores an innate Principle operating in every individual – impulse to make life meaningful and enjoy being ‘here’ on earth. It assumes full choice, without any psychological life-history impairment, of every individual. It further assumes the speaker is “psychologically sound” by comparison.)
“Government never does anything efficiently and cannot be trusted to do so in this case.” (This ignores the founding fathers’ call for a country “of, by, and for its people”. If government is out of order, it is our responsibility to restore adherence to Principle.)
“I have worked hard to make sure I can afford insurance and others must do the same.” (This blatantly sets Principles of Justice/Compassion aside by refusing to recognize the commonality of human capacities for wellness and/or suffering. It also assumes each and every individual is Horatio Alger in the making. It assumes capacity to ‘work the system’ honorably, to amass profit and gain, without ever taking advantage of anyone at any time. It assumes a somewhat “pure” personal history. It assumes anyone with out means to acquire good health insurance is some kind of ‘leech’ on the speaker’s shot at well-being.)
“If we don’t have profit driving the system, no one will ever want to design better diagnostic practices, treatments, or medication.” (This one really gets me. It assumes the sole motivating factor for any human development at any time in history has been wealth accumulation. I certainly agree wealth accumulation has been a driving force, but not in every case! Sometimes individuals and groups are so vitally curious and interested in creating a new possibility that they pursue a goal to do so! Countless inventions across time have happened simply because someone observed a situation, had some ideas, and explored devices. Economic contribution in the form of investment can actually include expectation of ‘modest’ returns on investment. What IF, I ask myself, we had more opportunity in the world to pursue development with less emphasis on grand wealth as an outcome? The assumption that a present high-profit system is essential puts fear of non-development ahead of humane consideration. Fear ahead of potential. It ‘feels’ to me a very ‘clutchy’ response. A response lacking in imagination and vision. Unacknowledged fear.)
Another “fear” often lurking within objections to an American Public Health Care Plan that has no profit emphasis, is more deeply cynical. There is an assumption that we cannot operate on Noble Principle. There is an assumption that the ‘essential human’ is, at his/her core, corrupt and not to be trusted. There is an assumption that we have “proven” to ourselves that our most noble capacities are for naught. Bothersome and frustrating naggings that anyone who “wants to get ahead” would be well-advised to set aside. This particular cynicism is hidden behind a false belief that the only barrier to prosperous experience in life (health prosperity as well as more mundane) is “lack of individual initiative” to “get with the program”. There is an assumption that in “Principle” (note the use of quotes) only an irrational or neurotic (or lazy) individual would not want make wealth accumulation a life goal.
(*** My own ancestors arrived on these shores at two times in history – one family set arrived to escape religious persecution and religious wars in Europe; the other to escape war and requirement to serve in same – an early version of a pacifist act. Both sides had deep religious convictions that brought them here. Opportunity for material wealth accumulation was not among their reasons, has never played a role in family historical recitation. My family history includes prosperous families and times, but not emphasis on material accumulation.)
August 30, morning, additional “expressed fear” for above list: I do not intend to return and add on regular basis – list would grow too long! However, This concern has been expressed to me with deep sincerity: “It can cost thousands, totalling a few hundred thousands, for an individual to complete medical training. Should this individual not operate then in a free-market in order to re-coup costs? “. I have two points to make: (1) When you consider a well-paid life-time career, even without excessive fees collected, eventually such a debt should be paid off. If the dream is to practice, then the dream may be honored, it may depend on a dual-dream: one of income, one of practice; and the individual’s personal preferred balance of these two. (The ‘starving artist’ quandary — sort of.) (2) The cost of being well-trained as a medical practitioner is itself a problem that needs to be recognized and corrected! It serves no one in terms of health care delivery to use one existing irrational situation (cost of training and debt accrued) in order to prop up a second irrational situation (lack of basic health and wellness care for each citizen in our country.) (My second point is the one that should actually be used – no point in insisting on the ‘starving artist’ model, even if it contains some logic value.)
My Best To All! MaggieAnn