Today on rounds I had the most peculiar epiphany. All my life, I held the opinion that altruism and the pursuit of knowledge drove me into the study of medicine. On closer inspection, however, I realized that I am nothing but the artifice of a gross quotidian injustice. While a distinguished gentleman received a shower of unnecessary and foolish tests for what seemed a banal ailment, another man, unknown by the world and lacking health insurance, could not be transferred to a rehabilitation facility to hasten his recuperation from a disabling stroke. The first patient, fully enjoying the scope of our profligacy, was in his 70s; the second one, held hostage to the iniquity of our society, had not even turned 40. The first patient simply needed reassurance from an empathetic physician; the other needed many things that were denied. The first patient will continue living with occasional discomfort, even if he rarely saw a doctor; the other will die.
This was my brutal reckoning: I, like every other physician in this country, merely dispense privilege. How is this different from a car salesman, showing a happy face until insufficient funds betray the aspiring costumer? We become immune to the inequality of our health care system because, after all, have to see our faces every day in the mirror and surmise something respectable in the reflection. It was hard becoming a doctor, why not be proud of it? Can we accuse ourselves every day of being the pivotal gear of a wicked machinery? It’s easier to deflect the blame to someone else!
Then, I overheard a colleague capitulating to a health insurance company representative over the phone after a protracted argument. "I don’t understand... I can’t understand..." he perseverated, after the faceless bureaucrat denied a nursing home to a patient with dementia. His lament, pronounced too many times by me and every physician in this country, still reverberates in my head and fills me with indignation. Willingly or unwillingly, approvingly or disapprovingly, physicians are the foot soldiers of a society that wears a smart façade, but is completely empty beyond its surface. Chesterton wrote: "the walls of gold entomb us." We literally apply that verse to practice, relinquishing any vestige of poetry.
But we must be physicians in spite of ourselves, for medicine has a social mission. I did not read that in a philosophy book, but in the perplexity of those who are denied of health care. I became a doctor because of the patients who educated me, and am in their debt.
Universal health care is the aspiration of every decent physician and every just society. The Patient Protection and Affordable Care Act (PPACA) signed in to law is a step forward toward that goal. But this important legislation is now under attack. Its enemies almost exclusively resort to lies, while those who believe that the legislation does not go far enough seem to ignore that we live in a democratic society where not everyone embraces sound ideas like the “public option.” It would be strange indeed if every member of a large, complex society like America would be fond of each and every single provision of the PPACA .
Health is the pre-requisite of life and the pursuit of happiness. Without these, liberty is impossible or vain. Hence, it is inevitable to deduce that health care is a right of every citizen, of every human being.
Today, our society is at a crossroads. Will we look at injustice in the eye -as the abolitionists and architects of the civil rights movement did-, and push aside the nihilists and retrogrades who want to repeal PPACA; or will we continue fostering inequality, tossing a daily log into the fire that slowly consumes our society? Rome was not built in one day, but it surely exhibited vigor on many memorable occasions. Will this country be presented with a clean bill of health, or will we continue to indulge in the audacious hypocrisy that we live in a perfect citadel upon a hill, in the land of the free?