Health Insurance is a highly charged topic because personal decisions and the highest of stakes (life itself) are at the core of the debate. A definition of "health care" is difficult (if not impossible) to define in common with others who may have different values, beliefs and principles in our pluralistic society. Given the many differences in understanding and the widely variant private behavior this is a subject with strong emotional attachment. Life altering events can be totally unpredictable (like being hit by a meteor on the way to work) or the consequence of some long term habit that eventually robs a person of an ability to breath (like smoking). Many life ending events are a mixture of both chance and behavior that leads to a variety of outcomes which confound our sense of fairness and justice. In the end it is personal behavior and spiritual formation that influence how we face this issue of "health insurance" and there is no topic that could be more personal or controversial.
Some see "Health Insurance" is a financial product that pays for medical costs when our ability to live as fully as we wish is diminished. A diminished life may mean less than unlimited access to contraception, abortion of the unborn, sterilization, breast enhancement, sex change, sexually arousing drugs, removal of "skin flicks", teeth straightening or the need for cartilage repair due to an sport injury. "Health Insurance" can be seen by others as resources reserved only for the purpose of extending or saving life. The very definition of "health care" is a personal issue founded upon widely differing views of our human condition. It is hardly surprising that a national consensus is difficult with such widely disparate views of what "Health Insurance" should do. The lack of common vision about the definition of health care is especially true in a country that has a collection of persons from a wide variety of backgrounds, understandings and vision for living.
Chance plays a role in life that can be unsettling for those who prefer order, predictability and a humane sense of justice. Examples of how chance can work are innumerable and perplexing. One (true) example is one of the richest persons in the world with virtually unlimited financial resources met an untimely death despite the best care money could buy. In another example (also true) a child that has had cancer removed by surgery and is then scheduled for chemo-therapy by the best medical advice available. The parents decline the therapy despite the dire warnings of the medical experts. That child still survives, fully functional, thirty years later. Greater resources can and often seem to extend the lives of unfortunate victims (or even save them) but the resources may also fail and the irony is that sometimes the resources may hasten the end of life as well. Chance is difficult to deal with because it reveals in stark terms how insufficient our medical science is and how fragile our life is. Can a board of informed, educated and detached experts make better decisions about medical expenditures than individuals (or families) using resources personally available to those facing the end of life? Who can truly know the "right" decision? It is hard to fathom that pooled funds can satisfy the expansive variety of opinions people face with the end of life event arrives (as it always does). Chance in the case of health care is not predictable at the individual level where the values most personally dictate individual response.
The person who eats a healthy diet and remains physically active is much more likely, according to aggregate data, to live the fullest possible life. Despite the well known links of lung cancer to smoking, alcohol to liver damage, fatty foods to heart problems, sedentary life to physical incapacity people choose freely to smoke, drink alcohol, eat fatty foods and fail to exercise regularly. Others refrain from pleasures of smoking, drinking alcohol, eating deserts and spend hours each week trying to remain physically capable rather than enjoying multiple forms of entertainment. Should the person who has sacrificed and done without the pleasures that others have enjoyed pay the same premiums as the person who living with the pleasures of smoke, drink or delightful dessert? Does a personal sense of responsibility, self discipline and sacrifice also play a role in the cost of "Health Care"? Is it the job of the government to make sure that the person who lives healthy pay the same price for health care as the person who elects not to live healthy?
The personal formation required to rationally deal with our health and frailty is paramount and trumps both chance or discipline. If a person fears the final moment of a finite life then no amount of resources can go untapped to save them from eternal extinction. All concern for the financial condition of those left behind can mean little or nothing compared to the preservation of self at all costs. The devout and religious person who sees earthly life as a transient experience thinks of the comfort of those who remain (emotional and financial). The person dedicated to more than an earthly life knows that facing death with dignity can assist those who are closest and knows that opportunities can be provided with resources not used to extraordinarily extend life. A nurse shared (true story) a discomfort she had when a patient, after visiting with family, elected to have enhanced oxygen supply removed causing a quickened death. That nurse then realized that the person, of sincere faith, was ready for the end of earthly dwelling. In the Christian faith trials can be viewed as privilege (James 1:2-12) and life can end with the comforting fact that "Happy the man who stands firm when trials come. He has proved himself and will win the prize of life."
