Friday, September 11, 2009

Dr. Bill Roy: "A Few Billionaires, Millions of Paupers: Our 'General Welfare' In Sickness, Death and Bankruptcy"

Our lives are threatened by many factors in the natural world, and by other human beings. Leaders throughout history have been expected to protect their people from other humans, whether with clubs at the mouths of caves, or with today’s sophisticated weapon systems.

It’s no accident our Constitution calls for our leaders to “provide for the common defense.” No one denies this is the first duty of American presidents. Our most famous presidents, Washington, Lincoln, Roosevelt, were warrior-presidents.

The Preamble of the Constitution also calls for government--our leaders--to “promote the general welfare.” While this phrase is subject to less certain interpretation, public health and medical care have risen to the level of critical importance over the last 100 years.

Since the beginning of the 20th century, life expectancy has nearly doubled. The ravages of disease have yielded to the point we think not only in years of life, but in quality years of life. Those who died yesterday could have lived today.

My father was orphaned at age five when his mother died of pulmonary tuberculosis. He died at 43 of a heart attack that was initially undiagnosed. I nearly died after my appendix ruptured in the year before penicillin was available. In 1995, I could hardly walk; since hip replacement, I have no pain.

Think for just a moment of the significant medical events in your family, and how they have determined life or death, well-being or misery for you and your loved ones. You will surely conclude medical care should be available to everyone.

But medical care is expensive. It requires one-on-one attention and advanced technology. Today we spend more than any other nation on health care, one-sixth of the total value of all goods and services, thus consuming resources that could pay for other needs and wants.

But we do not make care available to everyone. Our uniquely commercialized medical care system makes a few billionaires and millions of paupers. No one has ever claimed it is fair.

Yet our combined achievements are poor. American life expectancy is shorter than those living in similar nations. Our newborn mortality is high. 45 million Americans do not have financial access to medical care. Some die; some 700,000 annually go bankrupt. Others do both.

Today, while we celebrate warrior-presidents who have provided for the common defense, other nations also celebrate leaders who have promoted the general welfare by making medical care available to everyone.

Germans celebrate Otto von Bismarck who in 1883 began Germany’s universal health care system that exists to this day. The British celebrate Lord William Beveridge and Aneurin Bevan who established their highly-valued National Health Service in 1949. Canadians in 2004 named Tommy Douglas, father of their Medicare for all in the 1960s, the greatest Canadian of all time.”

Of note, the British went to the polls weeks after Germany surrendered in 1945 and defeated man-of-the-century Winston Churchill and the Conservative Party. They elected Labour Party candidates who promised them universal health care. Once in place, even Margaret Thatcher worked only to improve it.

Bismarck, who had led his nation for three decades, said in his last days that while his diplomatic and military triumphs might come to nothing, “The products of state socialism will dig themselves in.”

Meanwhile, all over the world among the first thing nations do after they achieve wealth is establish universal health care, to the extent that we stand alone among industrialized nations in our insistence on the therapeutic benefits of social Darwinism.

This week, backed into a corner by reckless opposition that more highly values political gain than the health of their constituents, President Barrack Obama plead with Congress to pass his modest proposals for health care reform.

He identified we are the only industrial democracy without universal health care. Unfortunately, the president failed to also recognize that no other nation in the world tries to run their health care system with private, for-profit health insurance companies.

As long as we do, we will not only fail ‘’to promote the general welfare,” but will continue to waste trillions, while sentencing at least 20,000 of us to unnecessary deaths each year.

Dr. Roy may be reached at

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