We Can't Pick and Choose

Earlier this week, Mark Hyman bravely took a stand on human trafficking, saying that it’s a bad thing. Hyman continues “Keen Grasp of the Obvious Week” by speaking out against poor people being cut off from dialysis.

Stating his support for bipartisan legislation that would provide greater reimbursement for dialysis treatment for those with end stage renal disease (ESRD), Hyman says that by following his advice and contacting members of Congress, viewers will save hundreds of lives.

As with the commentary on human trafficking, there’s little to be against here. Perhaps there’s a diabolical pro-ESRD lobby out there somewhere, but I’m not aware of it. And perhaps there are rival proposals that might do more for patients than the specific legislation Hyman champions, but the upshot of the commentary, that the government should do more to help those incurring huge costs for life-sustaining treatment, is a given.

But there’s a larger issue lurking here. Why should the government act to solve this particular medical cost crisis and not others? Hyman rightly notes that a disproportionate number of those with ESRD are poor and/or members of minority groups. But such people are also disproportionately members of the uninsured generally. It’s fine to have legislation that helps these individuals get the treatment they need, but would it not be even better to have legislation that provided health coverage for them before they got to the stage where they needed dialysis to stay alive? For that matter, wouldn’t investing in preventive healthcare for all citizens be better than paying large amounts for very expensive treatments (such as dialysis) after things go wrong? And wouldn’t the problems with healthcare costs that wildly outpace inflation be more manageable if the healthcare industry were not run exclusively on a for-profit basis?

As with the recent legislative escapades involving the late Terri Schiavo, it seems that conservatives are oddly selective when choosing what healthcare issues to pay attention to. Congress meets late into the night and the president flies back to Washington to create legislation that attempt to provide ongoing care for a woman who only has shreds of her brain left and no hope for recovery, yet millions of children go uninsured.

The premise behind both the conservative position on the Schiavo issue and the abortion debate, that human life is so inherently precious that we must protect it at all costs, no matter how incomplete it might seem, is a defensible one, and is in fact a position for which I have quite a bit of sympathy. But if we accept that premise, we must see it through to its logical conclusion and not apply it only in cases where there are political points to be scored with particular interest groups.

If human life is of such inherent value that even a brain dead woman eking out a bare biological existence should have everything humanly done to preserve her life, then we must acknowledge our collective responsibility to protect the wellbeing of all those living in this country, including the kid in the Chicago projects who isn’t getting enough to eat, the undocumented immigrant working as a maid who is afraid to seek prenatal care for her unborn baby, and the assembly line worker who can’t pay for the medication that would help treat his clinical depression.

To do anything less is to be less than a society that truly values life.

And that’s The Counterpoint.