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Gary Puckrein

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The Democratization of Health Care: The Higgs Field and Health Care Reform

Posted: 07/24/2012 4:04 pm

Almost simultaneous with the Supreme Court decision on the Affordable Care Act (ACA) was the announcement by the European Organization for Nuclear Research (CERN) of the identification of a subatomic particle that appears to confirm the existence of the Higgs field. The two can be considered in the same thought. The news from CERN signals how far we have come; the Court's decision reminds us of how far we need to go.

Discovery of the Higgs ranks with the breakthroughs of Newton and Einstein. The finding suggests that mass, the stuff we recognize as matter, is not entirely resident in the structure of atoms, as we once believed, but derives from an interaction between those atoms and the Higgs field, and perhaps other fields, that pervade all space. Through this interaction, the Higgs field contributes to the origins and composition of matter, the building block of life. Without the Higgs, our universe, we could not exist.

Serious scientists speculate that aliens exist. Extraterrestrials may have found the Higgs long ago, but until they make their presence and their achievements known, it would appear we humans are the only sentient life-forms in the observable universe capable of understanding the forces that gave us life and the only ones capable of manipulating those forces to our advantage. (Perhaps we should seek to conserve what may have no twin -- just a thought.)

The ACA litigation was part of the national health care debate. Among the questions to be resolved: Should our health care system be universal; should we extend its healing powers to everyone--the poor, those with diminished physical or mental capacity, seniors, those whose intemperance compromised their health--as we would provide for the rich and for those in their productive years; and under what authority can the federal government make medical care universal?

The science that brought us to the Higgs field reminds us that humans are freaks of nature by virtue of our singularity. Our evolution has traced a unique path, and we thrive only in a narrowly defined ecosystem. The latter raises a practical scientific and policy question: Can we regulate our ecosystem to establish an equilibrium that conserves sentient life? The Higgs, and science more broadly, will not only challenge our classic view of self, but will also inform future societal choices and priorities.

Our ancestors were obliged to accept maintenance of their health and well-being as a baffling, random struggle where chance routinely overrode knowledge and skill. Medical science is teaching us that we can reverse that relationship. We can know the origins and composition of matter, as well as the causes and progressions of diseases. We can use that knowledge to sustain lives. Knowledge presents the societal choice as to how widely to disseminate medical information, bringing health care into the democratic process.

If medical information today were as limited as it was in the days of the first Chief Justice, John Marshall, the number of uninsured would be of no political moment and today's Chief Justice, John Roberts, would have no need to cast the deciding vote. But our ever-increasing medical knowledge translates denial of coverage into a deliberate, societal decision to devalue a life. On the other side, if we widely propagate the means of survival (in the vernacular of the current debate "insure the uninsured", "place no cap on medical expenditures for seniors"), consumer demand for health care will necessarily rise.

Some see a problem with increased demand for medical care. They contend the health economy will grow too large, crowding out other industries and investments. They want to cool consumer demand by regulations. They propose that we tier medical resources, using rules that deselect people from optimal medical care. They do not openly discuss the structured disparities that will be a product of their design -- consumer demand cannot be constrained without sacrificing lives.

An alternative that does not have the fatal design flaws of the former, is a free-market health economy in which government provides means tested premium support for private insurance. The idea is to have universal coverage, but allow the purchasing power of consumers, not the preferences of payers (public or private), to drive discovery and distribution processes. Investors and innovators will chase the prize, burgeoning demand, and as the century progresses discoveries will improve outcomes while driving down cost.

The Higgs field is the 21st-century beacon for what is possible. Such discoveries should be our guide. The necessities that drove us to seek shelter in caves will always persist. What is changing is our growing capacity. Capacity breeds choices. In health care, we should choose to design a system powered to provide optimal medical care to each individual, to conserve life. As sustainability becomes our prime directive, and the crystal ball says it will, how we organize the provision of health care will become as important as the discovery of the Higgs.

 
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