The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

Reid uses the fictional examples of CEO Wendy Wilbur and poor laborer Juanita Gonzalez—two, 48-year-old single mothers diagnosed with ovarian cancer—to illustrate the inequality of the US health care system. Wendy saw an oncologist who removed her ovaries. She recovered completely after her surgery and, due to access to medical technology, can expect to live for many more years, cancer-free. Conversely, Juanita never went to the doctor because she had no health insurance. She ignored her pain and continued working until the pain became so severe that she could no longer work. Juanita died before turning 50 and left her teenage daughter orphaned.

In other industrialized nations, both women would have lived. Though Juanita’s story is fictional, it happens to tens of thousands of Americans each year. Most European countries, however, have recognized the universal right to health care in their national constitutions. After World War II, Italy’s recently formed democratic government included the protection of health in its Bill of Rights. At the time, the country didn’t have the resources to institute universal health care, which wasn’t created until 1978.

Now and again, an American goes to court and argues for his or her legal right to medical treatment on the basis of inalienable rights, as written in the Declaration of Independence. No American court, however, has ever upheld this argument. Interestingly, the only Americans who are guaranteed health care are prisoners. Judges have ordered prisons to provide care to sick inmates.

Reid asserts that the reason why Americans allow so many of their fellow citizens to die due to a lack of health care is because they are unaware of the problem. Even President George W. Bush once declared, in 2007, that anyone who needs treatment can just go to the emergency room. This isn’t true. Moreover, hospitals are not required to provide care to anyone who cannot pay. The only reason why hospital emergency rooms are required to treat patients who face death is because of the passage of the Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA), also known as the Patient Anti-Dumping Act. Under this law, any hospital receiving Medicare funds must treat those who face the risk of death or severe injury or illness until the patient’s condition stabilizes. It’s impossible, however, to go to the emergency room for routine treatment or to refill a prescription.

In addition to ignorance, Americans have never sincerely engaged in an ethical debate about health care. When asked whether both rich and poor children who are sick, for example, should have the same access to care, most Americans would likely say “yes.” However, many members of the American Medical Association disagree, arguing that Americans would have to be taxed to ensure care for the poor sick child.

Reid argues that not everyone will have access to the full range of testing and treatments, but Americans should agree to provide everyone with access to some basic care, as other countries have. Once, the US answers the fundamental ethical question about whether everyone should have access to health care, it can ask more pointed questions about which treatments to make available and how much citizens should pay in taxes and premiums to fund the system.