Tuesday, February 5, 2013

First do no harm


12 December 2012
First Do No Harm: Universal Healthcare is a Human Right
            The Universal Declaration of Human Rights states that “all human beings are born equal in dignity and rights (Article 1).”  When discussing the topic of human rights many things come to mind.  For example, all humans have the right to life, the freedom to believe as they choose as long as they don’t infringe on the human rights of others, and the right to a fair trial.  All human beings also have the right to comprehensive healthcare. In the United States there is currently no form of universal healthcare.  It is estimated that over 45 million Americans don’t have health insurance and of those 18,000 die each year due to lack of health insurance (Furman 2).  Medicare and Medicaid is there to help out the elderly, disabled and the poverty-stricken but there is currently no program in place to help all Americans that fall in between.  Americans that work but don’t qualify for health insurance through their employers often don’t have alternative ways to get health insurance.  As a result many of them go without proper healthcare.  Denying someone healthcare because of their lack of health insurance is a violation of their right to life, an inherent human right.   The Universal Declaration of Human Rights also states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control (Article 25, Section1).”  In this essay I will explore universal healthcare and give supporting reasons why it is a human right. 
In recent years I’ve become increasingly interested in universal healthcare.  I’ve always thought that comprehensive healthcare should be available to all.  I saw the Michael Moore movie Sicko and was fascinated by the health coverage received in other countries.  The movie clearly has a biased view but I enjoyed it as a piece of entertainment and a great topic of conversation.  My personal view on universal healthcare is very biased as well.  I’m 27 years old, female, single, and uninsured.  I also have Multiple Sclerosis (MS).  MS is an autoimmune disease that attacks the brain and central nervous system.  I do have a vested interest in the United States developing some form of universal healthcare and I would benefit greatly if it did.  Having said that, I’m of the opinion that all Americans, insured and uninsured, would greatly benefit from universal healthcare.  We should all have a vested interest in seeing universal healthcare in the United States becoming reality.  A nation is only as good as its citizens.  The United States would prosper as a country with healthy citizens. We are all affected when American citizens are drowning in debt or dying because of lack of health coverage.  There are a lot more urgent matters sick Americans need to concern themselves with other than medical bills.  There are more important things a sick person should think about than how they will pay their bills.
             In my pursuit of comprehensive healthcare I researched the National Health Service (NHS) in Great Britain.  To me, the NHS is a perfect model of how all countries should format their health care systems.  All Americans have the right to comprehensive health care.  By that I mean that every American should be covered by a government provided health care policy and all treatment deemed medically necessary should be covered. 
            During my research I came upon an article entitled, “A case study in healthcare hell.”  This told the story of Jovan Rodriguez.  He never had health insurance in his life.  He was employed, healthy and never concerned by his lack of health coverage.  One day he found a lump in his neck that doubled in size over a few days.  He decided to go to the doctor and check it out to ease his mother’s concerns.  A few tests and a few thousand dollars later he was diagnosed with Hodgkin’s lymphoma.  Rodriguez applied for Medicare to cover his treatment.  He then had to apply for disability to qualify for Medicare.  Rodriguez wasn’t sick enough to receive help from the state.  According to the rules in his state, Rodriguez needed to require hospice care to qualify for Medicare.  His oncologist wrote him a letter stating this because if Rodriguez didn’t receive the treatment he needed he’d soon need hospice care.  He was quickly approved for Medicare and his prognosis improved.  Unfortunately he no longer qualified for Medicare since his health was improving.  Rodriguez was actively dying without health coverage.  His human right to life was being violated every time he was denied Medicare.  His mother accrued thousands of dollars in medical bills while trying to keep her son alive. 
            Caleb Medley has a similar story.  He is a victim of circumstance.  Medley is another uninsured American.  He was shot at the opening night of the movie The Dark Knight Rises.  Medley required numerous surgeries and is currently in a comatose state.  His family now has over $2 million dollars in medical debt.  They’ve started a charity online accepting donations to help cover Medley’s medical bills.  His family should be concerned with Medley’s recovery but the bills keep adding up for his treatment.  All of Medley’s treatment would have been covered under a system like the National Health Service. 
            On December 22, 2009 I was given a tentative diagnosis of MS.  From there I was sent to a neurologist to confirm the diagnosis.  At this time I was insured.  My insurance company took 6 weeks to approve a second MRI.  During that time I hoped and prayed that I didn’t have MS.  After the second MRI my diagnosis was confirmed and I was put on a drug to suppress my immune system.  My insurance took another 6 weeks to approve the medication.  I saw my neurologist every three to four months to gauge the progression of my disease.  With MS, the goal is to slow it down as much as possible.  Every MRI I had over two years had been worse than the last.  The progression of MS is tracked by lesions (white spots) seen on MRI’s.  I was getting about three new lesions every three to four months.  At times I wouldn’t get any new lesions but my old lesions were inflamed.  I experienced symptoms like parestethsia, vertigo, facial numbness, and cognitive impairment.  My doctor kept insisting we wait and see if the medicine would work.  I was placed on IV steroids to control the symptoms as my disease progressed.  After two years of treatment my doctor agreed that the medication wasn’t working but said he didn’t know how to treat me.  He first did some blood tests and discovered my body developed antibodies to my current medication.  There are six medications that can treat MS and since I developed those antibodies that meant that I couldn’t take four of those six medications.  I was left with two options.  The first medication was too risky for me because of my medical history so I decided on the second, but at this time I no longer had health insurance.  I was paying cash for my neurological visits.  The new medication cost $4000 per month so I’d have to apply for assistance from the drug company to receive the treatment.  (This medication cost $4 per pill in Canada.)  By this time I had quit working and was applying for Social Security and Medicaid to help with my healthcare.  I went back and forth to both and received no help.  During this period I was also seeking a second opinion from a new doctor.  Luckily the clinic where this doctor practices medicine is a not-for-profit.  It took a few months but I was able to be seen.  This doctor spent three hours with me reviewing the progression of my disease and said plainly, “Your MS is very aggressive and if you don’t get ahead of it you’ll be in a wheelchair before your 30th birthday.”  I remained on the new drug I had been prescribed by the previous doctor.  I am no longer burdened by the cost of medical bills.  I do need to navigate the red tape of the clinic but I receive the treatment I need regardless.  This clinic has to treat those that live locally regardless of their ability to pay but many aren’t so fortunate to live near such a place.  I still need other healthcare that I’m unable to receive due to lack of health insurance.  My medication is very risky and I need blood tests every three months to test my liver function.  These tests cost upwards of $400 and there is no charity that can assist me with this cost.  I also need to get a few heart exams that I’ve been unable to afford.  The heart test ranges from $600 to $1000.  I’m taking a huge gamble by continuing my medication without the heart test.  Many people have quite literally dropped dead while on this medication.  At the moment the benefits of this medication outweigh the risks. But it’s frustrating that I’m unable to receive the heart test I require because I can’t afford to pay for it.  Under ACA I will be able to purchase healthcare in the future.  Currently I cannot buy any form of health insurance because I have a pre-existing condition.
There is very little opposition to the idea that all Americans should receive medically necessary healthcare.  No one person would say that it’s better to let someone die than to provide them with the healthcare that they need to live.  The argument comes about when we start talking dollars and cents.  No one wants to pay the bill.  Many young Americans believe it would be unfair for them to be taxed to pay for the healthcare of the older generations.  There is also a strong opposition to the concept of socialized medicine.  In America we are taught to fear socialism.  I recall learning about different types of governments in elementary school.  I was quickly branded an outcast when I asked why capitalism was better than socialism.  As a child I thought that socialism sounded “pretty cool,” but my classmates went on the attack and listed the long list of reasons as to why socialism was bad. 
I was told things like, “The government takes all your money if its socialist” and “If you live in a socialist country like England you’ll have to wait two years to see a doctor if you get sick.”  Statements like this set me straight and taught me the evils of socialism.  Clearly my classmates and I were ignorant to the issues at hand.  My classmates were expressing the extreme views that had been presented to them by their parents.  The public at large often responds in a similar manner when approached with an idea that is new and different from the status quo.  The best way to combat ignorance is with education.  The American public will be more supportive of a universal healthcare system the more they are educated about how a universal healthcare system would benefit the country. 
The Affordable Care Act (ACA) has caused controversy in many states.  This act is commonly known as Obamacare.  There is fear that Obamacare is a form of socialized healthcare.  Under Obamacare all citizens are required to pay for their own private health insurance or pay a penalty.  Obamacare also extends the time that adult children can be covered under their parents’ health insurance policies.  Most importantly insurance companies will not be able to deny coverage to people due to pre-existing conditions under Obamacare.  The pre-existing condition clause goes into effect in 2013.  Under this law Rodriguez and Medley will be able to purchase health insurance.  Medley’s family will be able to buy a policy to cover his medical care. 
            The ACA does a lot to improve healthcare in America but it’s not enough.  Alternatives to universal healthcare are discussed in an article in the New York Times by Uwe E. Reinhardt.  Reinhardt discusses the fallacies he sees in the ACA.  He sees the penalty that will be charged to Americans that don’t purchase health insurance as a tax.  Also it will be more cost effective for many Americans to pay the penalty rather than purchase a health insurance policy.  Many view paying for the health coverage of the less fortunate as unfair.  Reinhardt offers a few alternatives.  First he sees implementing insurance like the NHS where everyone is taxed accordingly as a solution.  Many fear this option because it would be a form of socialized medicine.   He also offers the option of a sort of hybrid program to please all.  Under this program citizens can choose to purchase private insurance or opt for government health insurance.  Those that opt for government coverage will be taxed to pay their share but they’ll also have the comfort of knowing they’ll be covered should they need the health coverage.  The people that choose the private option will not be taxed for the health coverage of the many but they also will be unable to take advantage of what it offers.  Those under the private option will also have to pay their medical bills.  This would be a fair option since so many in the United States fear socialized medicine.  American citizens would have their right to life placed in their own hands under this option and therefore their human rights wouldn’t be violated. 
            I have given three separate examples of extreme cases where people’s lives, myself included, have been adversely affected by not having healthcare.  That is just a small window into a much larger problem.  Many everyday Americans are affected daily by the lack of health insurance.  The cost of healthcare keeps many lower middle class Americans from receiving the healthcare they need.  Should American citizens suffer in illness or die because of their inability to pay for health insurance.  Some will say that they aren’t responsible for the healthcare of others and shouldn’t be taxed for such a thing.  The important thing about universal healthcare is that it is for all.  Should there be universal healthcare?  Before answering this question ask yourself these three questions. Would I want my mother treated if she became ill and was unable to pay?  Would I want someone to help me if I was diagnosed with cancer and couldn’t pay?  And lastly, would I want someone to help me if my child contracted some illness?  If you answered yes to any of these questions then your answer is yes there should be universal healthcare.   A nation is judged by how it cares for its citizens.  We should be proud as Americans and we should want to be known for taking care of our citizens. I believe this quote sums up the current state of healthcare in the US and as a nation we should want to change it. Russell Brand, the comedian, said this when comparing the differences of Great Britain and the US.  "Instead of truck, we say lorry, instead of elevator we say lift, and instead of letting people die in the street we have free healthcare."




Works Cited
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Furman, Jason. Who has the cure?: Hamilton Project ideas on health care. Washington, D.C.: Brookings Institution Press, 2008. Print.
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