Tuesday, December 30, 2008

Prescription For A Healthy Democracy

I have been mulling this for awhile now. Anyway I look at it, a democratic nation cannot sustain its central ideals of equality and citizen participation without every person in the land having access to affordable health care. Let me elaborate. It is not that the democratic principles and ideals are less important than health care- though one might argue that indeed life and limb are more important than the idea of free speech and equal rights. But that is a false dichotomy in that while health care is important to physical existence, democracy (when it works) meets a higher need to self-determine. Both are essential to the human condition in their own complementary ways.

The idea of democracy sets a vision of self-governance, fairness and justice that nations, which believe in dignity and rights for all, aspire to. A nation that pursues this democratic ideal, however, needs other accouterments to ensure that not only do all people within its boundaries have dignity and rights but that other factors, such as poverty, ill-health and illiteracy, do not keep them from participating in the democratic process. If a nation has fabulous health technology but only a certain proportion of the people residing within its borders can avail themselves of it without going into debt or otherwise bearing financial hardship, then what good is the existence of the most sophisticated democratic apparatus or even health apparatus? Most of those who cannot afford health care will either die early or be poorer and unhealthier and thus, less likely to exercise their right to vote. How do I know this? I know that when I am suffering from something as innocuous as a bad headache, I am not prone to thinking intellectually about the things that I could be doing. I only do those that I absolutely must do to keep going or rely on family for help. Most of us humans are like that. When we feel a threat to our health or that of our kin, we do go into something of a survival mode.

My point is that without universal health care, over time a nation skews its democratic process to favor those who can maintain better health. If in that nation health care is expensive and employment related, then these are generally the employed and the wealthy. So even though Lady Liberty might welcome the "tired, poor, homeless and the tempest-tost," she cannot guarantee them the basic right to good health which will ensure that they are as able as anyone else to participate in the democratic process throughout their lives which are no shorter or unhealthier than anyone elses.

Check out this powerful poster I found on the web. Makes the point nicely.

Addendum 31 Dec., 2009 - Lest people think this blog is only about the US, let me clarify that this applies also to other democratic experiments such as in India. There, while all citizens are supposed to have free public health provisions, one has but to look at the state of public-funded clinics and hospitals to know that corruption has way-laid the resources. The Indian democratic experiment while vibrant in some ways, weighs oppressively on the poor who do suffer from ill-health and early demise. All democratic nations NEED to provide universal health coverage for all people (not just in name either) in order to be a fully-functioning and true democracy.

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