Nation’s dilemma on show at Grady

Don’t misunderstand. I feel sorry for the dedicated leadership of Grady and its board, who, after decades of having nonpaying patients dumped on them by every other health system in town, is thoughtfully trying to find treatment alternatives for their patients.

But Grady, and its financial inability to continue providing life-sustaining treatment to its patients, epitomizes the failure of our current health system.

Inherent to reforming our health system is answering questions about who we are as a country and what are our values.

More specifically, do we as a country believe in health equity — that everyone who lives in America has the right to health and access to health care? The inalienable rights to “life, liberty, and the pursuit of happiness” included in the Declaration of Independence would seem to include health. It is, after all, hard to live and be happy if you don’t have access to opportunities for health.

Yet at a recent town-hall meeting, to the cheers of her fellow health reform opponents, a woman asked “What makes you think because you wake up in the morning you have a right to health care?” In other words, just because you live and breathe doesn’t give you any rights to health or health care.

Are those really our values?

Somewhere along the line, our independent, free market American culture decided that this most basic of rights — the right to have good health and access to quality medical care — is not a fundamental human right.

We have accepted as morally and ethically acceptable that, in our great country, there are tremendous health disparities. We accept that our friends, neighbors and family members are more likely to be diagnosed with late stage cancer, and die from it, if they are poor, uninsured, or a member of a racial or ethnic minority. We accept that they are more likely to die during pregnancy or have their infant die shortly after delivery if they are poor or African-American.

Do we as a caring nation really accept this?

To be honest, I’m quite confused. Because many of the opponents of health care reform are the same members of the “pro-life” movement who cheered when President George Bush and the Congress intervened in the Terri Schiavo case in Florida. Is it OK for government, including the Congress and the president, to get involved in the decisions between a doctor and a patient when it promotes a political agenda, but otherwise, it shouldn’t be involved?

Does “right to life” only apply to the unborn and those in persistent vegetative states? Are the Grady dialysis patients not entitled to the care they need to stay alive? Because our current system doesn’t provide it, doesn’t pay for it, and Grady can no longer afford it? So where is the moral indignation among those who are “pro-life” shouting out that for these patients and for our country, this is no longer acceptable?

Too many in the so-called debate about health care have forgotten what it is we are debating. It is a debate about the health and well-being of all of us. And it is also a debate about who we are as a nation; about our values and beliefs. As an American citizen and a physician, I believe we are long overdue in achieving the promise of health equity for everyone in our country.

Dr. Harry J. Heiman is an Atlanta-based family physician and health policy analyst.

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