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Fortunately, there are no sick kids in America who need medical attention

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The news today is dominated by the story of Mohamed and Ahmed Ibrahim, conjoined twins from Egypt who were separated by doctors in Dallas during a 34-hour surgical marathon.

I’m a compassionate guy (ok, maybe I’m not), but stories like this really bother me.

To make life better – not to save their lives, even – for these two people from Egypt, some of the most talented American medical professionals swung into action. Consider these facts as presented by Children’s Medical Center in Dallas on the website built to fill the public’s hunger for information about Mohamed and Ahmed:

• The surgery occurred after a “year of intense preparation” that included “extensive diagnostic tests” and “customized surgical equipment”

• The surgical team included more than 60 members of the hospital’s medical staff, including five neurosurgeons, two craniofacial surgeons, a pediatric plastic surgeon, a pediatric general surgeon, an oral surgeon, nine anesthesiologists, six pediatric nurses, six surgical technologists, four respiratory therapists, four anesthesia technicians and support staff

• The separated twins will now spend about a week in the hospital’s pediatric critical care unit

• Follow-up care will include reconstructive surgeries that will be done in stages and could take several years. The twins will travel from Egypt to Dallas for the surgeries

• The direct costs of the initial surgery are $125,000, with total costs estimated to be $2 million. The World Craniofacial Foundation raised the initial $125,000 to pay the hospital

• The surgeons, hospital and “hundreds of professionals” involved have donated the time they have spent and will spend on the twins’ care

… all to make life better for two people from Egypt.

I don’t find references to public money being spent, so I’ll assume this project is mostly a private effort – the money comes from donations, the hospital, surgeons and staff chose to donate their time, etc.

But how can the hospital, its surgeons and staff and the people who donated to this cause justify all of this? Sure, it’s a feel-good thing to make life better for these twins, but what about the opportunity costs?

I’d hazard to guess there are plenty of children in Texas whose lives could be made significantly better if these medical resources were made available to them rather than devoted to making life better for two people from Egypt.

How about spending that “year of intense preparation” providing pre-natal care for poor women in the state? I bet there are plenty of poor pregnant women who could use “extensive diagnostic tests”.

Why not use the 10 surgeons and support staff occupied by the twins to perform neurosurgery, craniofacial surgery, plastic surgery, general surgery and oral surgery for procedures for children who need those surgeries in Texas or elsewhere in the U.S.?

Instead of more reconstructive surgeries and follow-up care for these two people from Egypt, maybe you could perform reconstruction on car accident victims who otherwise would remain disfigured?

Perhaps the $125,000 (and ultimately $2 million) donated to make life easier for two people from Egypt might do more good if donated for indigent care at Children’s Hospital?

Couldn’t the “hundreds of professionals” who donated all this time for more than a year make more of an impact by donating their time at free clinics or by visiting schools to give poor kids the routine checkups they probably don’t get now?

And the hospital could have spent the time and money it took to create the special twins website on a site that provides better health information for the community.

But no.

In the judgment of the hospital, its doctors, nurses, support staff and the people who donated the money for this procedure, making life easier for two people from Egypt is a more important cause than anything else that could have been done with these tremendous resources.

And multiply this by the number of times we see this happen – remember the conjoined Guatemalan twins at UCLA – and there are no doubt thousands of people in the U.S. who could benefit from the time and money being devoted to the care of a handful of people who are fortunate enough to tug at the heart strings of America.

I find that sad.

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About Capn Ken

  • ClubhouseCancer

    The sentiments expressed herein are nauseating.

    Firstly, the argument that “every dollar that goes to these is one dollar subtracted from others’ care” is fallacious, and shows a remarkable lack of real-world knowledge about public health policy, charitable foundations and the way a hospital works.

    Referring to the twins over and over again as “people from Egypt” makes clear the writer’s agenda. We get it. Christian American whites with money go first, brown poor foreign Muslims last.

  • Indeed. I can’t go to doctors. No money, no insurance. And I feel thrilled, ecstatic, joyful, and grateful that these kids are getting the help they need. No disrespect is intended to the author of this posting, but wow, dude. How can anyone fault folks who are helping children, whatever their place of residence? Wow.

  • Ken, you are missing something here. The thing you are missing is the publicity machine. The medical personnel and the hospital will get ‘paid’ by becoming more high profile and more sought after. Donors will notice, too. So, there is really no long range economic loss to them. (For more on the topic, take a look at Wired. There’s an article on why the operation on the Iranian twins was a success for Raffles Hospital and its neurosurgery star, though it should never have taken place.)

    CC, though Ken is a conservative, I believe he is also a person of color. So, if he is being prejudiced, it is probably as a nativist.

  • ClubhouseCancer

    Exactly, MD. Xenophobia. Ugly.

  • Wow, y’all know a lot about me, don’t you?

    First off, I don’t know where ClubhouseCancer comes up with the idea that I’m saying “every dollar that goes to these is one dollar subtracted from others’ care” (or why that’s in quotes – certainly not a quote from my post). I said nothing about the choice to undertake this surgery meaning that care is “subtracted” from others. I talked about opportunity costs.

    And it’s a fact that in time and money was spent to make these kids’ lives better, and that was time and money that could have been put to some other use. If you feel the best way to spend that time and money is for two kids from Egypt, fine. But I disagree.

    I think all that time and money would be better spent on healthcare for thousands of people. And since it’s American resources, I’d rather see it go to American people, but it would also be preferable in my mind to improve the health of 1,000 Egyptian people than just these two.

    Secondly, what makes you think I’m a Christian?

    Thirdly, for Natalie Davis, yes, I can fault doctors and the hospital for choosing to devote all of this time and money to help two children rather than deciding to spend the time and money to help thousands of children.

    Fourthly, yes, it’s a PR play for the hospital. They would get very little publicity for expanding indigent care programs or doing other things that don’t make world headlines. Again, I find that sad.

    Fifthly, who said I was a conservative?

    Sixthly, who said I was a person of color?

    For the record, I’m a white guy, I’m not a Christian, Jew, Muslim or member of any particular religion and I’m a libertarian.

  • I disagree with Ken on this one for numerous reasons. Regardless of money, these cutting-edge cases produce new medical knowledge and that alone would justify them.

    At the same time, his point is worth considering, not dismissing out of hand with a wave of disdain. Where is the line between our citizens and those of other countries? What level of preference for our citizens is proper?

    Excessive resort to the phobias and isms relieves people of considering the difficult and uncomfortable ideas that Ken has raised.

  • I think too much is being read into my calling these kids “two people from Egypt”. Yes, I believe it would be more beneficial for these talented surgeons to be more concerned about the health of Americans, but that’s a secondary point. Sorry if it muddied the waters.

    My main point is look at the resources laid out for the benefit of two people and think about the impact all of those resources could have had on the lives of thousands of people had the hospital and doctors chosen to put them toward that.

    I stand by that. I think it’s a shame.

    And as for the research aspects of doing the surgery, the type of conjoining suffered by the Egyptian twins is the rarest type of conjoining – occurring in just 1 out of every 2.5 million deliveries worldwide. How much value is there, then, in learning how to separate them?

  • My error, Ken. I am confusing you with another Ken, apparently. Hats off to the pale guy-:).

    However, I stand by my concern about nativism. Businesses are no longer ‘national.’ Borders are porous. Much of Europe needs to import people from the Second and Third Worlds. Under those circumstances, does it make sense to think of ‘us’ and ‘them’?

    Furthermore, humans are hardwired to respond favorably to kids. That is why we take care of babies instead of abandoning them, despite all the work involved. So, you are fighting a losing battle in that regard. Children, especially very cute babies like these, will always win.

  • Diva: It’s just a shame that only these two kids are “winning”. Wouldn’t it be nice if all of these resources were used to help improve the lives of thousands of kids who could use the resources?

  • ClubhouseCancer

    The Cap’n wrote:

    “I think too much is being read into my calling these kids “two people from Egypt”.”

    What was your reason for using the phrase 5 times in a pretty short post?
    To repeat a phrase over and over and then wonder why people make a big deal out of it is disingenuous.

    As to your points that apply to me in comment 5:
    1. My summary of your “argument” may not please you, but I think it reflects the spirit of (your words):
    “Perhaps the $125,000 (and ultimately $2 million) donated to make life easier for two people from Egypt might do more good if donated for indigent care at Children’s Hospital?” and, from your comment, “And it’s a fact that in (sic) time and money was spent to make these kids’ lives better, and that was time and money that could have been put to some other use.”

    2. I wrote that your “argument” infers primacy for White Christian Americans over black Muslim foreigners when it comes to health care. I never ascribed any such characteristics to you.
    This also addresses 5 and 6.

    I applaud the Diva’s denunciation of “us vs. them” attitudes. She expresses the crux of the argument against views such as the Cap’n’s much more succintly than I.

  • Something to consider with regards to these types of high profile procedures: the hospital may benefit from the donations of wealthy people who saw this and wanted to do something positive with their income. So while they’re making life better for these “people” (that is very odd sounding, by the way) they also raise awareness of the hospital, as well as take part in cutting edge surgery that will eventually, even if only in some small way, benefit everyone.

  • CC:

    – I think too much emphasis is being put on my point that these are Egyptian kids, not American. I do believe American health care resources are most appropriately spent on residents of America before the rest of the world, but I see that my references to the kids being from Egypt clouded my overall point. My fault.

    – There’s a fundamental difference between the idea that “every dollar that goes to these is one dollar subtracted from others’ care” (which is what you accused me of saying) and what I actually said, which is that the time and money spent on these kids could have been put toward programs that benefit a lot more than just these two kids. There’s no “subtraction” here. If people are donating money and time, that’s additional resources. And the donors, hospital and doctors made a choice of how to spend that money and time. Can you dispute that?

  • I’m generally disgusted by the idea that we shouldn’t take care of these kids because other kids need help, too – or help more, even. I live in Dallas, and I know that my church prayed for those two young boys yesterday, and I was glad to do so.

    But though I was prepared to object to the article, Cancer-man just trips me out. “White Christian Americans?” I read the article as “the needs of the many outweigh the needs of the few” and maybe “us before them,” but I don’t see where the “white Christian” part comes in at all. Project much? Not once did the author reference the color of the children’s skin or their religion. For all we know, they’re Christian kids who happen to have the names Mohamed and Ahmed.

    Cancer-man, you introduced both race and religion into this discussion, while I suspect the Cap’n would be just as offended at white Christian kids from Europe getting this sort of treatment.

    For practicing compassion, consider this as a mental exercise: What if Cap’n Ken lost a baby sister when he was a younger man because his family lacked the money to have a needed operation? Would it maybe then be a little more understandable that he is annoyed that millions of dollars and large teams of doctors are working to help kids for publicity value while they let his kid sister die?

    I personally suspect that the Cap’n is just hard-hearted, but I could be wrong. From a purely dollars-and-cents perspective, he makes a good point. How many cases of infant malaria could be treated for two million dollars?

    Fortunately, Children’s Medical Center of Dallas takes care of something like 250,000 kids every year, so I think that the kids of Dallas are well-served. And I think that if two “white Christian” kids were joined at the head as awkardly as these two Egyptian kids were, they’d get special treatment, too.

  • Ken, for the record, I did not charge you with any phobia or ism.

    Would I prefer thousands of kids to be helped? Indubitably. But I am glad these two could be helped.

    Do I think Americans should get preference? No. I don’t value Americans over anyone. All lives are of equal value in my worldview.

  • The problem I have with this whole situation is illustrated by the last two posts.

    Phillip says perhaps I’m “hard-hearted” because of my opinions here. But then he says “From a purely dollars-and-cents perspective, he makes a good point. How many cases of infant malaria could be treated for two million dollars?”. And that’s my point exactly. Is it “hard-hearted” to have a preference that all of this time and money be spent to improve the lives of thousands of kids rather than just two kids? I don’t get that.

    Natalie says “Would I prefer thousands of kids to be helped? Indubitably.” Well, if you would prefer thousands of kids be helped, you should be unhappy that they weren’t.

    I think most of the comments here echo the problem this represents as a whole: When a situation like this comes up, it gets attention, and then gets money and time. But people don’t stop to think about what that money and time could do if applied to the significant but not uncommon problems of others.

    And, again, I think this is sad.

  • FWIW, fellow Blogcritic bookofjoe is a doctor himself, and he agrees with Ken.

  • Ken, I have a thought on this that will perhaps help you see why I object to your reasoning, though I find it logical. I’m pretty busy right now, but I’ll try to write it up and either post it here or as a new post. It might end up being long. 😉

  • Phillip: I’d love to hear a logical rebuttal. I’ve been called heartless, anti-Christian, uncaring and just about everything else, but there’s been very little logic coming back. 🙂

  • For the record, I defended you! The seed of my though is found within my comment, but I’m leaving for lunch now. I suspect when I return I’ll actually post a new post, so that I can more easily include links and quotes and type a longer post. Is that okay?

    That is, is it okay with you to link back to this post? I know I could do it anyway, and I assure you that I’ll be respectful, but I’ll start that respect now by asking permission.

  • Ken, some of that nonsense is sadly typical. Attacking you and classifying you as an enemy is all too often a substitute for debate. You fascist bastard.

    I’d think that the research has value for applications beyond separating this type of fusion–am I wrong?

    And Ken, your thing on Trot Nixon was interesting, though I differ. I see nothing wrong with him vibing off a personal relationship with JC or the G-Man (although I wouldn’t mind a “one deity reference” maximum in all sports interviews).

  • ClubhouseCancer

    So what is his point? That no super-expensive surgeries be performed? If so, why the emphasis on where they’re from?

    As to my injecting race and skin color into this, these kids were brown and Muslim, and the Cap’n knew this when he posted. There must be a reason he emphasized “two people from Egypt” (5 times), and he won’t tell us what that reason is (rather, he says the commenters are putting too much emphasis on the phrase, which he used five times). My assumption is that it is code to signal their race and/or religion, a common tool. Backing down from it when called on it is common too.

    He may be against, as Phil suggests, the same situation if white Europeans were involved, but of course he has never said that.
    Now who’s projecting?

    And Cap’n, I’d say the difference between your phrasing and mine is hardly a “fundamental” one, but if you want to exaggerate rather fine distinctions, that’s cool.

  • CC: Either you’re not able to see my points or I’m not able to see yours, so I’ll end our string on this.

  • Eric Olsen

    Perhaps Ken’s point would have been more readily made if he had pointed out the irony of the situation rather than couching it in terms of good or bad policy. The main logical problem I have with it is that the money/time involved with the procedure isn’t zero sum as I understand it: it isn’t EITHER yank the noggins apart OR cure cancer, etc. It’s a little more fluid than that.

    Also I think the “do it for the pure science” argument pretty much always holds up, and the analogy is the space program. There are all kinds of surprise uses for techniques and knowledge gleaned fom pushing the envelope in any area. The issue isn’t how many people will actually ever need THIS PARTICULAR PROCEDURE, it’s that what is learned in the process may be applicable elsewhere.

    That said, there is still plenty of irony in spending that kind of time and money on two kids from Egypt when millions have inadequate care here. But if you follow that logic through, there would be no foreign aid, no space program, etc.

    Life IS ironic.

  • Chris:

    Since you brought up my Trot Nixon piece (thanks for digging deep into Cap’n Ken’s Homespun Wisdom, by the way), I’ll go ahead and defend my statements there, and no doubt incur the wrath of some Christians here…

    I also don’t see anything “wrong” with Nixon believing that Jesus was swinging the bat for him, I just find it amusing and rather ridiculous. And the point of my piece about it was to show, if we are to believe Trot, what Jesus chose to also allow to happen that Saturday when he was helping the Red Sox win their game.

    And, yes, I do tend to point out things I find ridiculous about “Christians” from time to time on my blog.

    For anyone wondering what Chris and I are referring to, it’s a post I put on my own blog called Thank you, Jesus, for keeping the Red Sox alive.

    My other offensive Christian posts:

    Will Jesus do it for 5%?
    Another Boy For Jesus

  • “Natalie says ‘Would I prefer thousands of kids to be helped? Indubitably.’ Well, if you would prefer thousands of kids be helped, you should be unhappy that they weren’t.”

    Where, with all due respect, did I say that I was not unhappy that thousands of kids were not being helped? All I said is that I am happy that these two kids were. The two are not necessarily mutally exclusive positions.

    I refuse to be sad that two innocent children may have a chance at a good life and that others may as well, thanks to the knowledge doctors gained from this experience. And I will not say that I wish these kids had been left to die or with their heads joined, because I could never wish such a thing, however logical you may find that desire.

    You, I suspect, are looking at this from a purely public-policy perspective. Well, there are many bad policies; it is obvious that the way in which health-related dollars are apportioned is one of them. However, if the money came from private sources, none of us has a say over how that funding is spent. I would prefer for people who spend money on porn and guns would spend it instead on donations to medical research or assistance to the poor and needy, but it isn’t my call. In the case of these two kids, the money indeed could have gone to many other situations, it could have cured or helped many more children. Was helping these two the best choice? Probably not. Was it a bad one? I would say no, because, as it presently appears, two valuable lives were saved.

    My only reaction can be to thank the doctors and to thank God. If that makes me illogical in your eyes, so be it.

  • Natalie:

    Also with all due respect … I didn’t intend to say you were not unhappy about the thousands of kids who could have been helped but weren’t, I just said you should be unhappy about it. So if you are unhappy, then you and I agree on this issue.

    Didn’t mean to accuse you of anything there.

  • Cancer-man, I’ll type this really slowly this time so that you can understand it, okay?

    Let’s break the offending phrase down, shall we? There are four words: “two,” “people,” “from,” and “Egypt.” I suggest that Ken meant exactly what he said, and no more.

    I believe that he used the word “two” to emphasize that we’re talking about two people. Less than three, more than one. Two, in comparison with the hundreds or thousands that could have been helped in some way given the same amount of money and time. Many vs. few, remember?

    I believe that he used the word “people” because the twins are people. He could have said “Moslems” or “Arabs” or “moochers” or anything else if he had wanted to, but he didn’t. He said “people.” I might suggest that “children” or “kids” would have been more precise, though not any more or less accurate, but since he was making a largely economic argument, it might not do to build too much sympathy for the kids.

    I believe that he used the word “from” because the kids aren’t “from” here, meaning America. There is at once the possibility of pride, that Children’s Medical Center of Dallas is famous all over the world, and the possibility of making the point Ken made, that American children should probably be first in line to receive American dollars and American time. I’ll address that point separately, but that’s all he said.

    I believe that he used the word “Egypt” because that is where the kids are from. Again, this might have been the perfect time to insert something about the color of the kids’ skin, or the religion of their parents, or whatever else if he had wanted to. However, he didn’t. You introduced both race and religion into the argument, not Ken.

    Was either consideration a factor in Ken’s thinking. I don’t know. I’m not Ken. I also don’t tend to assume the worst of people, something you’ve done in this conversation. You could always ask him whether those were factors, instead of accusing him.

    Actually, you keep coming back to the point that Ken used the phrase five times. Let’s see how significant that is, shall we?

    Below is a list of all references to the twins within Ken’s posted story, complete with compare and contrast phrases, starting with the title:

    • contrast: “sick kids in America.”
    • “Mohamed and Ahmed Ibrahim”
    • “conjoined twins from Egypt”
    • “two people from Egypt”
    • “Mohamed and Ahmed”
    • “The separated twins”
    • “The twins”
    • “the twins”
    • “two people from Egypt”
    • “these twins”
    • contrast: “children in Texas”
    • “two people from Egypt”
    • contrast: “poor women in the state”
    • contrast: “poor pregnant women”
    • “the twins”
    • contrast: “children…in Texas or elsewhere in the U.S.”
    • “two people from Egypt”
    • contrast: “car accident victims”
    • “two people from Egypt”
    • contrast: “indigent care”
    • contrast: “poor kids”
    • “twins”
    • contrast: “the community”
    • “two people from Egypt”
    • compare: “conjoined Guatemalan twins”
    • contrast: “people in the U.S.”

    Hey! You missed one! I count six references! Note the lack of mention of religion or race?

    Now let’s compare your first comment:

    • “Christian American whites with money”
    • “brown poor foreign Muslims”

    Funny, Ken’s list seems to specifically mention “poor” a few times, but not on the side of the equation you list it on. The only words in your list that seem to accurately represent Ken’s story are “American” (sometimes by implication, other times explicitly) and “foreign” (though Ken doesn’t use that word, the concept is clearly expressed).

    I’ve said a few times that I disagree with Ken, and I know why, and I really will post why, but your comments are obviously not based on the reality of Ken’s post. If you want to read between the lines and insert some sort of agenda in there, that’s fine, but please acknowledge that it’s projection on your part, and please avoid inserting agenda points (“poor”) that are clearly contradicted in the piece to which you’re responding.

  • ClubhouseCancer

    Thanks for the slow typing, PW.

    Otherwise I’d never understand your nuanced arguments in favor of denying these twins (I think they might be from…Egypt?) a life-altering operation.

    I’m sure that Cap’n Ken meant nothing by his repetition of the phrase. He probably didn’t even know these kids were brown-skinned Muslims.

    Referring over and over again to a person’s country of origin is never meant to winkingly indicate the person’s ethnicity or religion. I don’t know what I was thinking.

    In short, the Cap’n’s arguments are clearly just his brilliant economic analysis of the inequities of our health-care system. Thank God I have slow-typing Phil to disabuse me of the notion that his post had something to do with race or ethnicity or religion.

    Of course, a note from Ken during the four or five post-string might have done the same. Maybe I just missed it.

  • kara

    I think Ken’s absolutely right, and absolutely entitled to his opinion. Yes, there are things that can be learned from this type of rare surgery, but the fact is, this type of “rare” surgery has been performed multiple times in the U.S. recently.

    It’s comparable to every zoo in the U.S. wanting a panda. Every big hospital wants a risky conjoined twin surgery to get their name in JAMA and a big research grant.

    And that’s fine. But since there are a finite number of doctors in the U.S. a finite number of hours in the day, and a finite amount of time doctors are willing to work “pro bono”, I think it’s fair to say that time and resources spent on these high-risk, highly-publicized procedures is time NOT spent treating local patients with everyday ailments who deserve as much medical attention as these conjoined twins do.

    I hope the twins live a long and happy life. But I hope nobody else went without a much needed heart transplant or chemotherapy treatment so that they could have it.

  • Wow, Cancer-man, your attempt at irony is overshadowed by the obvious fact that you still don’t get it. I typed as slow as I could, and you still confuse “I’ve said a few times that I disagree with Ken, and I know why, and I really will post why,” with “nuanced arguments in favor of denying these twins…a life-altering operation.” Um, try again.

    I’ll say it one more time: Ken gave factual statement that you flat-out misrepresented at least once (“poor”), rudely assumed the worst about at best, and generally didn’t bother to try to understand.

    I don’t agree, and I’ve now finally posted my reasons for not doing so, but at least I made the effort to understand where he was coming from. It’s the compassionate thing to do, you know.

  • ClubhouseCancer

    Apparently your empathy doesn’t extend to me, only to Cap’n. As for “rudely,” I don’t remember implying that the Cap’n can’t read. How rood.

    I’m still waiting for an explanation why the kids’ country of origin was mentioned six (thanks, PW, for the correction) times. Seems naive to continue defending him. If he had some other reason, he would have stated it. Your childish word-by-word breakdown must have been fun to write, though. Do this sentence next:

    “She sells seashells by the seashore.”

    Also, please pose another mental exercise for me to complete. This is not didactic or presumptious at all, and I’d never be able to think up such fascinating hypotheticals on my own.

    I agree with your new post (not sure why it’s a new thread — seems an extension of this conversation to me). You, like me, recognize that it’s not a zero-sum game economically. This was the part of my posts that I guess you didn’t read, but your more complete analysis seems to me to be right on.

    Sorry if I misrepresented your position.

  • Would you have preferred that Ken say “two foreign kids?”

    The accusation of xenophobia was, in my opinion, not far off the mark though I object to the term. This had nothing demonstrably to do with Egypt per se, except that Egypt = not here. Like I said, I see no indication that Ken would have reacted any differently had it been two “white Christian” kids from any country that isn’t America. Maybe he would have reacted differently, but that’s a question to ask, not an accusation to hurl.

    There you go, I even used some Latin to try to make up for the condescension earlier. I guess it’s because you said such nice things about me over on the other post. 😉

  • ClubhouseCancer

    Eric and Taloran told me it was spelled “purr say.”

  • I just want to add that I am not against millions of kids getting medical care instead of two. My ex, a physician, and I, used to discuss the topic pretty often. He was opposed to most transplants because they aren’t cost effective. He might have opposed this operation (based on likelihood of success). What I am thinking about the little boys is similar to what Eric said. It isn’t either/or. In fact, we could do both as a nation. Americans have a quarter to a third of segments of the population without healthcare because we allow our leaders to screw us that way. That is a separate issue from charity care to indigents by volunteers.

  • kara

    “Americans have a quarter to a third of segments of the population without healthcare because we allow our leaders to screw us that way.”

    Not to get off topic here, but since when was the “Right To Free Health Care” in the Constitution?

  • Eric Olsen

    I can’t imagine that a people who view themselves as compassionate and civilized, and who theoretically don’t allow any fellow citizens to starve or freeze to death, would not also say all fellow citizens are entitled to basic health care.

  • It’s a loaded phrase, Eric. When you say “basic health care,” what do you mean? Because there are people in this country who believe that it includes cosmetic surgery, and teeth-whitening, and liposuction, and on and on, and that is what frosts a lot of people who aren’t heartless or uncivilized, but resent doing without so that others can have more.

  • Not to get off topic here, but since when was the “Right To Free Health Care” in the Constitution?

    what exactly is all that “general welfare” stuff in the constitution anyway?

    i’m not saying that this means there is a right to free healthcare….

  • Eric Olsen

    basic non-elective health care for everyone and their mother – the horse they rode in on will have to wait

  • As much as a love constitutional law, I am not going to hold forth on the question asked. Instead, I would like for Mark, Phil, Kara and anyone else who wants to, to write blog entries about why they think basic health care (let’s define it to exclude cosmetic surgery and dental care) should or should not be considered a right. I look forward to reading what y’all have to say.

  • Eric Olsen

    And again, don’t forget that health care debate. Please see your email from yesterday and let San know if you’d like to participate.

  • When it comes down to it, MD, I believe that the very word “right” has been so twisted away from it’s original meaning that it can be used to justify anything. Nobody has the right to compel anybody else to do anything, and that includes the right to compel the government to collect taxes from other people (and by extension the right to compel others to pay those taxes) to pay for my medical procedures or anything else.

    We have the right to be left alone inasmuch as we leave others alone. We have the right to life, liberty, and the pursuit of happiness. We have the right to “do,” not to “have done.” And health care, basic or otherwise, is not something we “do,” it is something we “have done,” so it is not a right.

    That said, we live in one of the most prosperous nations on earth, one based more than most others on the belief that all men (and women) are created equal, starting from the same point at birth. If we can’t afford to provide some level of health care for everybody, what does that say about us?

    BTW, I believe that the law does demand that all people be given emergency medical treatment without consideration of their ability to pay. But “basic health care” is obviously different from “emergency medical care”.

  • Joe

    Then there’s the whole public choice theory aspect of it where the right to free healthcare becomes the right to better healthcare. And then there’s means testing, etc… I don’t see any easy solutions.

  • Here is what you have a right to:

    The U.S. Constitution

  • Here is the law of which I was thinking. It’s CA law, I used to live in CA. I’m not sure what laws other states have, but I believe that there are similar laws in most states.

    I guess the question is where we draw the line between true emergencies on the one hand and cosmetic boob jobs and penile implants on the other.

  • Ken, that’s not the blanket answer you seem to think it is. The Constitution basically recognizes that “the people” have all rights, and proceeds to limit the rights of the government.

    Beside, what does it mean exactly, to “insure domestic tranquility” or “promote the general welfare”? What are the “blessings of liberty?”

    The rights of people are only mentioned in passing, along the way of limiting the rights of the government. For example, we are not guaranteed the “right of the people peaceably to assemble,” but rather Congress is expressly limited from making a law abridging our right. The right was assumed.

    Remember, “[t]he enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.”

    So if someone says that they have the right to free health care, how does the Constitution rebut that point?

    It doesn’t, except as a pattern.

  • Sorry, that Constitutional reference was meant as a joke for people looking for a “rights” handbook. I guess it didn’t come across as I intended.

    And, yeah, “we” basically have a “right” to anything “we” decide “we” have a “right” to.

    And, in my mind, “we” are a dangerous bunch of goodie grabbers.

  • Cute, Cap’n. You know, SCOTUS Justice Hugo Black used to carry a copy of the Constitution in his pocket. When challenged, he would pull it out and argue directly from it.

    Phillip is going in the direction that leads to where the law is in regard to the ‘right to health care’ issue. Rights are not necessarily enumerated in the Constitution, principles are. Instead, they evolve with society. However, once a right is conferred, it must be applied with equal protection and is difficult to take away. Have we evolved to the stage where basic healthcare is such a right?

  • Like I said, Ken, I think that there is a difference between rights to do or be, which are inalienable, and rights to coerce others, or have things done for us or to us.

    My right to free speech affects you not at all, and my right to pay for a chin implant affects you not at all, but my “right” to a free chin implant can be more accurately (I believe) stated as a “right” to make you pay for my chin implant, which obviously affects you.

    People can get into verbal contortions so elaborate that they hurt themselves, trying to create “rights” that don’t exist, but I think the rule I’ve outlined should be a good determining factor.

    Even then, there are some gray areas. Over time we’ve come to accept a widened definition of “harm” to include mental anguish and emotional distress, concepts that I suspect were not in the minds of the original framers of the Constitution.

  • Kara

    It’s not a matter of whether or not you have a “right” to health care. But I don’t think ANYONE has a right to demand the Federal Government or anyone else to subsidize it for them.

    I’m not soulless or hardhearted. I just think that charity should be in the hands of churches, families, and non-profit charitable organizations, NOT the Federal Government.

    Frankly, one of the things I love most about America is the fact that I mostly am free to make my own decisions about how and where I live and how I care for myself and my family. It’s the job of the government to “govern”, not to feed, clothe, and house. We ALL have the right to basic requirements for life, but with that right comes the responsibility to provide them for ourselves. Once we give up the responsibility for our own lives, we lose the freedom to choose how we live them.

  • kara

    This is what socialized healthcare nets you:


  • I’m not soulless or hardhearted. I just think that charity should be in the hands of churches, families, and non-profit charitable organizations, NOT the Federal Government.


    so, a single mother, living below the poverty line….gets sick at work….very sick…she’s taken to the hospital and is diagnosed with appendicitis…and must have an operation.

    she has no health benefits.

    who pays for it?

  • kara

    1. Doctors can not refuse to perform surgery to repair immediate life-threatening injuries or conditions based on whether or not she has insurance. She’d get her surgery. And the hospital would negotiate their rates with her based on her income.

    2. If she’s a member of a church, the congregation should come together and make donations or hold a fundraiser to come to her assistance.

    3. If she’s not a member of a church, she should appeal to the local Salvation Army or Goodwill for assistance.

    But it’s still her responsibility to do those things. Just because she’s poor doesn’t mean she’s absolved of any responsibility for her own needs.

    And it doesn’t mean my taxes should be raised to pay for her surgery. Rather, I should voluntarily donate a sum that I determine I can afford to the charity providing her funds.

    Social responsibility is one thing – armed robbery at the hands of the Federal Government is another.

  • the hospital will negotiate their rates with whom? the surgeon?

    i’m not saying that being poor absolves somebody of responibility.

    what i am saying is it’s a fantasy to think that charities will be able to pick up the tab for things like this, because we’re talking major dollars.

  • kara

    I said: “And the hospital would negotiate their rates with her based on her income.”

    Meaning that the hospital would negotiate with her to lower her bed and food and medicinal costs required in addition to the surgery. The surgery costs would also be reduced.

    Have you ever heard of anyone dying in the United States because they didn’t have insurance and couldn’t afford the health care?

    Have you ever heard of a major hospital suing an indigent or elderly person for being unable to pay their medical costs?

    Catastrophic healthcare in the US is already “free” or at least available at greatly-reduced costs to the uninsured and indigent.

  • Have you ever heard of anyone dying in the United States because they didn’t have insurance and couldn’t afford the health care?

    just because i haven’t heard of doesn’t mean that it doesn’t happen.

    plenty of people have no access to heathcare…causing a degradation in health over a period of time…which certainly can lead to death.

    and who, extacly, is picking up the tab for this “free” healthcare you speak of?

    part of the answer to that would be “everybody”…because the drag on the healthcare system increases the cost over time.

  • kara

    So what’s the answer, Mark? Sure, hospitals increase their rates on non-indigent patients to cover the costs of the indigent. Part of that cost is eaten insurers, who then raise premiums. And part of those premium hikes are covered by big businesses who do offer health insurance. And they cover those costs through salary adjustments.

    So, should the Federal Government take over and hike taxes to provide centralized health care?

  • i’m not saying i have the answer. i was just pointing out that the problem is very complex…and just stating ‘not with my taxes’ is too simple a ‘solution’.

    …since we are picking up some of the cost indirectly already.

  • “Catastrophic healthcare in the US is already “free” or at least available at greatly-reduced costs to the uninsured and indigent.”

    News to me. How? Where? Who?

    And is it a government program? I refuse to do the dole thing on principle.

  • Natalie, as I stated up in comment 42, if you need emergency health care, you can present yourself at any hospital with an emergency room and they are required to treat you as well as they treat any other patient.

    We all pay for that, indirectly. When I was unemployed for a long time, I took advantage of that once. Since then I think I’ve more than made up for the free Bronchitis diagnosis.

    But that only applies to emergency health care. Anything else is more difficult. No country deals with it well, ever. Canada has a health care system that drives people to move to the states to get surgery. The UK has situations like the one kara linked to earlier.

    I’m not particularly happy with what we’re doing in America right now, but then I haven’t really heard a better suggestion yet. Most suggestions seems to follow the rather simplistic logic of:

    1. We must do something.
    2. This is something.
    3. Therefore, we must do this.

    Sometimes the cure is worse than the bite.

  • Incidentally, I believe that emergency room condition is why you now find little “Urgent Care” clinics popping up here and there. With no emergency room, I believe that they are usually exempt from the requirement to treat people without any ability to pay.