Garrison Keiller’s Lake Wobegon is a magical place where, as Kieller liked to remind us with every episode of NPR’s A Prairie Home Companion, “all the women are strong, all the men are good-looking, and all the children are above average.” Wouldn’t that be lovely? Of course, there is no such place and instead we live in a world where the bell-curve of reality is that most of us fall in the middle of physical prowess, attractiveness and intelligence. Same thing goes for health.
On the far right of our bell-curve we have healthy people, on the left we have unhealthy, and in the center lie the vast majority of us who are muddling through the best that we can; a textbook example of a classic distribution. It would be lovely if we had a skewed distribution, one where the curve had very few folks to the left or center and the overwhelming majority were not just to the right but did right; right for themselves with proper self-care including but not limited to rest, exercise, food choice, disease protection and mental health awareness. Think of the increase in longevity, the decrease in medical costs, the abundance of joy an abundance of vitality could bring! That’d be great, but it isn’t what’s happening.
Instead of prevention most of us look to intervention. We break ourselves and demand that the world fix us. Prevention is hard. It takes personal effort. Intervention is costly and if we are not taking proper care of ourselves then our abdication of personal responsibility places a preventable burden on everyone around us.
A burden to everyone around us? You bet.
We have a nearly infinite demand for health-care services while the supply is severely limited. Economics tells us that things in high demand and low supply increase in expense until the supply, the demand and the price reach stasis, a fact that does not bode well for the treatment paradigm that is the current cornerstone of wellness and that does not bode well for the efficacy of Universal Healthcare.
Embracing intervention rather than working toward prevention is not an enlightened approach to proper self-care; unlimited intervention after the fact is in direct opposition to the demand and supply realities of the world. Humanity for our fellow humans doesn’t begin by wanting everyone to have access to healthcare, it begins by decreasing the demand and thereby freeing the supply for those in need.
When we act in opposition to reality, when we call Health Care a “RIGHT,” we set ourselves up for failure. “A Right?” We have the “Right” to demand that others care for us regardless of our actions? I think not. Any Right beyond Life, Liberty and the pursuit of Happiness must be balanced with an Obligation, or as I like to abbreviate it:
R = O + F/L
If We The People call for Rights that are not balanced with Obligation then we destroy ourselves from within.
Should access to healthcare go exclusively to the wealthy? No. But when we insist that others provide for us when we do not first practice self-care then we abuse the word Right to mean something sick, sinister and twisted; much the same way many of us treat ourselves.
Despite an adulthood where I have tried to care for myself well, despite working hand in hand with my healthcare providers to try to keep the incidence of intervention low, I have required half-a-dozen surgeries, been hospitalized a similar number of times and had a like number of prevention/detection procedures. I have reaped the benefits of a healthcare system designed more for intervention than prevention and I wish to deny this care to no one; but wishing doesn’t make it happen, doing our part to keep demand low does.
The first question each of us should ask ourselves is how we embrace, promote and inculcate a Healthcare System of prevention so intervention can be provided for the three-hundred-fifty-million people living in the USA. Boo-hoo-hooing, gnashing of teeth and wringing of hands will help no one in need and neither will wishing we lived in a Lake Wobegon world where, “all the women are strong, all the men are good-looking, and all the children are above average.”
There is a lot that’s wrong with healthcare but the single aspect over which each of us has the greatest control is the way we live our lives.