Why Universal Access to Healthcare Isn’t a Constitutional Right, It’s Just Plain Fair

But the main reason I go fishing is for the peace of mind, the ability to get away from the toils and troubles of daily life. While wading on slippery rocks, trying hard not to fall into 55-degree water, listening to the water rushing around my legs, and enjoying all the beauty above and below the water, I can go to a very special, serene place, where I empty my mind and think about nothing. It is a Zen-like experience, letting go of all that is not important at that moment in the water. It helps me get “centered,” whatever that means.

When Thoughts Intrude

Fly fisherman Kevin Shelley holds up a brown trout for a photo before releasing it.

Only twice can I recall the intrusion of thoughts that disrupted this state. One was a problem at work, which I realized I had to fix immediately so I could fish in peace. The second occurred after one of the debates in the recent Presidential campaign. I realized that universal access to healthcare is very important to me, and was troubled that so many other people did not share this view. Why did I believe this, and how could I explain my point of view to another person in a thoughtful and rational sort of way? For the next hour, I fished without success and could not get this issue off my mind, so I got out of the water, and decided that I needed to work this out.

First, I have a couple of disclosures to acknowledge. I am a life-long Democrat, and come by it honestly. My mother told me that when she was growing up in Buncombe County in western North Carolina, there was no Republican party. Although you probably don’t realize it, my home county most likely has entered your vocabulary. In 1820, Felix Walker was our notoriously long-winded Congressman, and insisted on delivering a long and tedious speech “for Buncombe” during the debate on whether to admit Missouri (my current state) as a free or slave state. A Washington, D.C., newspaper published his speech, and “buncombe” or “bunkum” came to refer to bombastic political oratory directed to the speaker’s constituency, without any prospect of contributing to useful debate. We have certainly heard a lot of that from BOTH parties in the last few years.

Second, I have never been in a true “private practice,” by which I mean running a small business as a single or small group of physicians. Since graduating from medical school, I have worked as a salaried employee, and have been largely insulated from the financial implications of which patients I see and how I practice. I have not had to balance a budget for a practice, ensure that there is enough revenue to make payroll for my employees, negotiate with insurance companies for reimbursement, and figure out how to buy health insurance for my employees. I freely acknowledge that I am woefully ignorant of the realities therein. Some of my fellows and patients have helped me understand some of these issues.