Where Goes Compassion?

Dean and Jason,

Thanks for the dialogue. Good thoughts.

Dean, you make an excellent point about my post answering its own question, in that the US does have the resources to meet the needs of its citizens, it is choosing not to.

I remember reading on the link you provided in your article about Floating Doctors, but I don't recall seeing the information you mentioned in your comment here. Thanks for sharing that. Very interesting and commendable. I admire their choices.

Unbelievably, I have to agree with Jason's comment about some people choosing the street, though I wouldn't have believed it if I hadn't seen it with my own eyes. I worked for the VA in West Palm Beach. We had a patient that had family who was willing to help, but even refusing family assistance, he qualified for placement with VA funds. He refused. He periodically got himself admitted for a few days' stay in the hospital, then he'd go back out onto the streets - by choice. But, the choice wasn't because the housing he was being offered was unsafe.

Jason, I'm having trouble discerning your comment about the fix, whether it was serious or sarcastic. Care to elaborate?

Thanks again, guys, for the comments.

Jason, when the choice is between the streets and a shelter, is it really a choice? If the system works the way it is supposed to, isn't state and federal choice really the reflection of majority choice? What you're essentially saying is that the majority of people lack the compassion to ensure basic needs for all, otherwise they would demand their representatives provide for it.

Re: Taxes, isn't your insurance premium a passive tax anyway? Taxes are high here in the UK, but we have no insurance premiums for healthcare if we want basic coverage. If we want to upgrade, it is the equivalent of 80 USD/Month. I'll bet your premium is bigger than that. The thing is, because the risk pool is so much larger (the whole UK) the individual cost is less. An NHS may not be the right solution for the US, but a single payor program would alleviate a lot of the problems.

You are right about the conditions on reservations and border towns, not to mention the projects of New York, Chicago, or the South Side of LA. As far as I recall, those places are all still part of states that do have funds and could make changes should they wish to. Lots of developing nations don't have that same advantage.

One sight I will not forget is when I saw a homeless person in LA digging through garbage just outside an eatery where the affluent were eating.  A sad sight indeed.

However, some are homeless by choice because the shelters and those that propose to protect them are more dangerous.  America has the means to feed, house, clothe, etc everyone who lives here and that becomes a state and federal choice whether the government wishes to do so.  

Would we be willing to pay more in taxes so others can benefit from our hard work?  Who will feed, clothe and pay my deductable for health care for my children when my paycheck is smaller than usually because the census is low?

Native American reservations can be just as inadequate to inhabit as any third world country and so can the shanty towns on US soil close to the Mexican border.

The fix, just as all other fixes happen, is to throw more money at the "problem".  

I have re-read this post a few times trying to come up with my response. Your frustration is palpable and I share it.

The US has prided itself on the ability to "pull oneself up by their bootstraps" and declining handouts. This ethos has extended into healthcare and politics. Ron Paul's example, early in the campaign, stating his belief that if someone doesn't purchase health insurance, they should suffer the consequences of their decision. This is where, I believe the error of perception lies. Most people who have no insurance probably didn't make that conscious choice. My post this week ruminates over a related dilemma.

Here in the UK, health care, basic as it is, is seen as a right. All persons have a right to basic care and society doesn't see it as a hand out anymore than they see the police or fire brigade as a handout. More superior care is available for a price, but nobody is without care.

Why do health care workers like Floating Doctors go elsewhere when there is so much to do at home? I think you have answered at least part of your question in your own post. The money is present to change things in the US. We, as a society, have chosen to not share those resources and to let people sink or swim. There are also huge regulatory and liability issues which impede providing free or reduced cost care.

Many third world countries, like Haiti, have no resources at all. Money is not hoarded by the fortunate few, there are no fortunate few except for some corrupt governments. The general public in developing countries suffer much higher morbidity and mortality rates than in countries like the US. There are no spare resources hanging around. The brother and sister who founded Floating Doctors are actually from Los Angeles and of a privileged family. They made the choice to give that up in order to provide for those with no resources at all. Could they have stayed and done the same in LA? Perhaps, but not on the budget they are working on in Central America, not without being strangled in bureaucracy and not having the broad impact they are having in numerous communities.

Your title is apt. I get asked frequently by people around me in England, when discussing the American health care system, "Where is your compassion?"

So how do we fix it?

Cheers and thanks for the thoughtful post.