First humanity, then economy

I was standing in line for coffee the other day chatting with a physician from Wenatchee Valley Medical Center about our nation's health care predicament.

Our conversation evolved into a discussion about the need for a greater sense of humanity in this country as we discuss health care reform, something that has seldom been at the top of the agenda in the ongoing debate.

There's been no shortage of white-hot rhetoric around efforts in Congress to expand access to health care. There are legitimate questions about the legislation that is taking shape, particularly the ability of the plan to bring down the cost of care. To the extent the reforms being considered fail to reduce costs, expanding the rolls of those who are insured will increase the costs of an already exorbitantly expensive system.

As the owner of a business that provides health care insurance, that makes me nervous.

So from a dollars-and-cents standpoint, it's easy to see why the status quo is appealing as we face all that uncertainty. But we cannot escape the fact that if millions of people working at lower-wage jobs can't afford health care, the status quo means they are likely out of luck if they get sick. We're writing them off.

While the national debate centers on economics, the physician and I talked about people. He told me about a woman who had recently gotten a job that included health care, got a checkup and discovered she had cancer. Unfortunately, her insurance company was able to drop her because it was diagnosed so quickly and it was therefore a pre-existing condition.

That's the smart economic thing for an insurance company to do, because increasing shareholder value is the only reason it exists. Increasingly, it seems that as a society we are willing to let people like this woman fend for themselves. If they can't afford insurance, that's too bad. Those of us who can afford insurance have the luxury of looking down our noses at those poor schmucks.

The good news in the woman's situation is that the medical center stepped up to provide charity care. In this particular case, that amounted to a six-figure contribution.

It seems unrealistic to expect the medical profession to bear the brunt of caring for folks who are uninsured. We know those costs end up showng up elsewhere, so we are paying for the care in some respect.

So the real question is whether as Americans we're willing to write off the low-income folks as far as health care is concerned.

This particular physician told me he was supportive of efforts to increase access to health care while acknowledging that major changes need to be made to bring costs under control. Humanity, he seemed to be saying, should come before economics.

As I reflect on all of the rhetoric, that approach seems like a much more humane response, one that is more consistent with the values on which this nation was founded than the debate we're having.

We have developed a habit in this country of fantasizing about perfect solutions with no risks. If we wait for that perfect solution, we will never make meaningful progress. The entrenched interests of insurance companies, pharmaceutical companies and consumer groups are too powerful, and it's too easy to find fault with any reform.

I agree with the physician that it is better to begin by taking steps that affirm our humanity and figure out the economics along the way. The world will not stop revolving, regardless of what the talk show hosts say. Businesses, individuals, insurance companies and drug companies will find ways to make adjustments.

Reform will never be as good as advertised nor will it be as bad as predicted. Let's begin by focusing on humanity and accepting the challenge of working out the economics later.