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ON the Cost of Other People
(Are other people too expensive?)
by Larry Drain
Much of what you do with other people, as an individual, as a family, as a member of a group, as
a member of society, depends on how you answer one relatively simple question: Do you think
it is possible for other people to cost too much?
Think about it for a moment. What do you do when someone costs too much, when they require
more than you feel they should get? The options are relatively few. You can in some
way try to reduce the cost. You can do that by trying to increase the burden to them, or
you can try to increase the benefit to you if you are going to have to incur more cost. You
can try to set a limit and just refuse to pay. Tell people if you require this you are just
going to have to do without and accept those needs will not be met. Or all other options
being exhausted you can simply say: "You're not worth it. I refuse to pay
anything."
Most of us like to see ourselves as giving people. We expect to do for others. We
hope others will do for us. We look down on people whose lives seem to be defined solely by
how much they can get, how much they can accumulate. We look at the message of Jesus which
seems to be that others don't cost too much. "Love your neighbor…"
In many ways it is a spiritual question, but it is a spiritual question with immense practical
implications. It defines, I believe, the difference between our health system and those of
many other countries in the world. We believe that many times people just cost too
much. They require too much. They take too much and ultimately they are just not
worth it.
It is a question that you can not get around answering. Either you believe people are worth
it or not. In Tennessee, depending on the counts you listen to, it appears that somewhere
between 140,000 and 180,000 are going to lose their TennCare. Already
one in six Tennesseans are without any kind of insurance. The kinds of problems these
people have are the kinds that most of us see as our worst dreams: cancer, organ
transplants, kidney failure, AIDS, mental illness, heart disease, and any other number of genetic
disasters that seem to make living a happy life impossible. Almost everybody knows
somebody or knows of somebody that is in this ballpark. Their diseases, their disorders,
have real and drastic consequences in their life. Those consequences have consequences for
those around them and for society in general. Whether we pay or not we can not avoid the
cost. To believe different is to simply be a different species of ostrich.
The debates on health care are all fueled by our central belief: people can cost too
much. Everybody seems to chime in on some side of the issue. Make them pay
more. Make them get less. If you are not careful things will get out of hand.
And when all else fails do what Tennessee does: tell people you're not worth it and I
refuse to pay anything.
What many local communities learned in 2005, though, was that although the state could refuse to
pay, they could not avoid the cost. For example, the mental health system in this state has
huge gaps and holes. The jails have become our biggest mental health centers.
Experience has shown that locking people up has little therapeutic impact on those who are truly
mentally ill and the only sure thing is that with little or no other resources those that leave
are coming back again. It is not because the mental health system has people in it who do
not care. Resources just don't begin to meet the need. The message to the mentally
ill has too often been you cost too much. Insurance benefits rarely meet needs and too
often the mentally ill are left to their own measures to deal with their illness.
In Blount county, where I live, to get an appointment at the local mental health center can take
eight weeks or longer. For someone with a severe mental illness, eight weeks can be an
eternity. What is someone to do? What would someone with a physical illness do?
The answer is simple: get sicker and sicker—and they do.
Somewhere around fifteen-thousand to twenty-thousand people with mental health disorders will
lose their TennCare this year. That is a lot of people with no access to medication or
treatment who suffer from a disability that has high impact on all to simply let go. I
don't know what portion of these will fall to Blount County, but it seems likely that we are
going to cover difficulty with disaster. And we will all bear the cost.
It should not be a crime to be sick, but all too often it is. There are people over the
next year who are going to be more severely punished than any criminal in any jail. Because
they live in a time when gas costs too much and there is not enough taxes collected, they are
going to be left to their own devices to cope with life circumstances they would not wish on
their own worst enemy. If they ask why, they are going to be told: "We are just
doing what we have to do. You just cost too much. We are so sorry. Good
luck."
The Tennessee Health Care Campaign says healthcare is a human right. As long as our
healthcare system is based on making sure that people don't cost too much, healthcare will never
be treated as a human right. Times being what they are, people will always cost too
much.
Our healthcare system is nowhere close to the best in the world. There is a recent
Frontline documentary that talks about the health care systems in other democracies. It is
worth finding out about the results when you base healthcare, not on what people cost, but what
they deserve. For one thing, people get a lot more preventive care because they deserve
it. We need to look long and hard. Maybe the reason we are having such a hard time
finding the answers is that we are asking the wrong questions.
Think about it.
Thanks for your time,
Larry Drain
Hopeworks Community
http://hopeworkscommunity.com/
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