Our Obsession with the Wrong Patient History

Think, just for a second, about all the coincidences, choices, and unseen forces that have led you to this moment, sitting where you are and reading this blog post.

And — although I’m not pretending this blog is especially popular — imagine all the other people who have read or are reading this blog, along with all the coincidences, choices, and unseen forces that led to this shared moment.

None of your lives are the same. You are reading this for different reasons; you are sitting in different places; you are stealing free time from different work obligations; you are regretting different decisions; you are looking forward to different opportunities. To me, however, it’s not the path that led you here that matters, or even the fact that you are all going to ‘get’ something different out of this post. What matters to me is that you are right here, right now, sharing the same experience.

And the same applies to healthcare.

Too many people talk about the healthcare debate as if all that matters are people’s personal histories — all the coincidences, choices, and unseen forces that have led them to this moment when they need healthcare. This includes if they landed a good job with benefits, if they went to college, if their parents make good money, if they’ve taken care of their health, or if they came to this country legally. If any of these things didn’t happen, then perhaps they don’t deserve healthcare. If you did not come to this country legally — and can’t pay taxes — you aren’t entitled to use services paid for by taxpayers. If you came from a poor or working class family, or if you are working a job without benefits and can’t pay for insurance yourself, well — tough luck. Healthcare is not a constitutional right.

But think back to yourself, right here, right now, and everyone else who ever has or ever will visit this blog. What is the real difference between you, in this moment? What is the real difference between ‘how’ you are reading this post, or how much you ‘deserve’ to have this moment to yourself?

And imagine, instead, that you are all in need of medical attention. It’s not urgent — maybe it’s a pain in your hip that makes it hard to walk, or a persistent ache in your abdomen that you know isn’t a simple belly ache. Maybe it’s headache that won’t go away, or a heart that struggles a little too much when you walk up the stairs. Perhaps all of you, sharing this moment, have a weird spot on your shoulder that might be malignant, or a popping in your back, or a cracking tooth that makes it hard to eat. In this moment, what is the difference between you? In this moment, with all of you feeling the same pain, the same dull anxiety that something is wrong, the same realization that only a medical professional can fix this — in this moment, how can you say that one of you deserves healthcare more than the other? That you deserve it more than someone else? That someone else deserves it more than you?

I can’t say that.

To me, it is like someone starving to death in a grocery store because they don’t have money. Take a step back: a human being is in need of something essential for their survival, and they are literally surrounded by more food per square inch — more calories, more nutrition — than has ever existed in the history of the world. But, because the path that led them there is full of missteps and misfortune, that person is not deserving of the food that sits on the shelves around them. And don’t turn this into a euphemism — to say that someone without money cannot buy food is to say that someone without money doesn’t deserve food. But guess what — a hungry human being is a hungry human being. I don’t even care if the reason they have no money is because they have five felony convictions and no one will hire them.

Along those same lines, a sick human being, by virtue of being sick, is a human being who deserves healthcare. I don’t care if they came to this country illegally. I don’t care if they drink seventeen sodas a day and have ‘done this to themselves.’* I don’t care if they are poor or live in a rural area. That sort of ‘patient history,’ in terms of deserving access to care, shouldn’t matter. They are sick, or they soon will be. In the end, that’s all that should matter to us.

 

 

*fwi, it’s dangerously slippery slope to begin defining who ‘did this to themselves’ in terms of who is worthy of healthcare/respect/lower premiums on insurance. Do you exercise everyday? Nope? Then, to some extent, the heart disease you’ll have at 60 is your fault. If that sounds unfair, it is — and so are blanket statements about diet, obesity, and ‘deserving’ the health problems that come out of it.

Photo credit: yasamaster via Foter.com / CC BY-SA

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