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Deane Waldman Headshot

Do You Have a "Right" to an Oil Change?

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Imagine that someone gives you a brand-new shiny "fully loaded" car with a full tank of gas. After you read the owner's manual, you drive it off the lot, around town, and take an auto trip. When the gas gauge is low, you fill it up.

Your new car has an indicator that lights up at 10,000 miles to remind you that you need an oil change. You know this will protect the car, keeping it running longer, and preserve its value.

Question #1: Do you have a right to the oil change?
Question #2: If the fuel pump wears out after 100,000 miles, do you have a right to a new one? Hold your answers for a minute.

Imagine that someone -- God and/or your parents -- gives you a brand-new, healthy body, "fully loaded" (two kidneys not just one; two lungs not just one; and over 100 gigabytes of memory in the brain case); and never before used. What do you do with it?

Question #3: Do you fill up this healthy body with good gas (fish and vegetables); with cheap, watered-down gas (cheetos and French fries); or with jet fuel (cocaine)?
Question #4: Even on the highway, do you drive under 20 miles per hour (no exercise)?
Question #5: When the reminder light goes on -- time for a routine medical check-up -- do you demand your oil change for free because it is your right?
Question #6: When the fuel pump becomes clogged (when your arteries or your gall bladder are blocked) do you expect the repair shop to do the work for free, because it is your right?
Question #7: When your car engine burns out after two years of jacket-rabbit starts and no maintenance, do you have the right to a new engine for free (someone else pays for your decisions)?

Most people would have no trouble answering Questions #1 and #2. I suspect most might have increasing trouble answering Questions #3 through #7.

Obviously, I am asking you to think about health care as a right. What does this mean to you? What do you think it means to your neighbor, and to all of us collectively?

Can you have a "right to health care" without any responsibility: both by paying for it and by being an active partner in it? Can you have a right to anything that compels someone else to do something: isn't that called slavery? For instance, what happens to your right to health care if no one goes to medical school? (Applications have been falling since the mid-1990's.)

Even if we all had health insurance, does this automatically translate to health care? What if all the hospitals closed or there were no nurses, certainly no experienced nurses?

As we grapple with the health care fiscal crisis, we must not lose sight of reality. If you change any one part of the system, like the financing, you will have effects on the other parts whether you want to or not. Everyone agrees that health care as a system is broken. Yet we treat parts of the system in isolation (separately) not the system as a whole and never ask why the system stays broken.

Part of the reason why the system stays broken is that we have never as a people come together on the "right to health care." Until we have a consensus about what that means and what it implies, including the responsibilities that go along with the rights, the system will remain broken and no amount of tinkering with the dollars will make it work.

(For people in countries with so-called "universal health care," their health care is an entitlement, not a right. To the extent that their peoples accept their responsibilities, financial as well as personal health maintenance, their systems work. Where people demand a "right" to health care and reject co-incident responsibilities, their systems too are broken.)

Do you have a "right to health care?"
What does this mean: to you and to all of us?

PS. Just watch. Some will comment with anger directed at me. As Spider Robinson wrote, "Anger is always fear in disguise." By simply asking this sensitive question, some will assume that I do not believe health care is a right and that is highly threatening. I cannot guarantee much in health care but this I can: if we cannot openly discuss the sensitive questions that remain unresolved in healthcare, the system will stay broken.