From the outset, the conversation was framed by the assumption that health care resources are necessarily scarce. Society, it was assumed, would be crippled by the costs of health care, unless they were carefully rationed. The notion that we might organize society to make health care a top priority was characterized as absurd. Society, it was declared with table-thumping authority, must be organized around higher ideals than the good health of all. What are we, animals?
In the years since that seminar, it has seemed to me that most policy discussions about health care begin and end with very similar table-thumping assumptions about the nature of society, its highest aims, and the presumed scarcity of health care resources. Time and again, health care discussions begin with the assumption that we must do more with less, instead of discussing how we might do much more, if only we realigned our priorities.
Fortunately, during a crisis like the COVID-19 pandemic, most everyone seems to understand that we have a duty to do everything we can to keep as many people as possible as healthy as possible. At a time like this, it is easy for most people to understand that society can’t function if everyone is ill, dying or dead. Moreover, people also seem much more willing to do much more to prevent all ill-health, suffering and death — perhaps, because the consequences are top-of-mind. Unfortunately, once the crisis passes, if past experience is any measure to go by, it seems likely that people will very quickly forget their present concern for the good health of all.
It is important to remember, I think, that the costs of preventable ill-health, suffering and death are as real when they happen over time as they are when they happen in a wave. Admittedly, the high volume of health care needed during a pandemic is a unique challenge in its own right, but the actual suffering caused by preventable ill-health, suffering and death doesn’t disappear when it is spread over time. It may be less dramatic, more easily managed, and more easily hidden from view, but all of the costs remain: human, social, and economic.
So, if it is true during a pandemic that we should do everything in our power to keep as many people as healthy as possible, I think, it should also be true when there is no pandemic to focus our attention. Our good health is the very foundation for everything else we value — whatever we might value.
I don’t care if you are financier, a poet or a small business owner, your pursuit of the good life is not possible without your good health and the good health of everyone else.
This pandemic, I hope, has reminded us of that fundamental fact.
The good news is that this pandemic will eventually end. It will end precisely because we are making its speedy resolution our top social, political and economic priority. The bad news is that, once the crisis is over, we will likely fall back into that old habit of thinking that the good health of all is a priority easily trumped by other considerations, like the marginal tax rate of our wealthiest citizens. It is my hope, however fleeting, that our response to the COVID-19 pandemic will remind us that we can accomplish much, when we align our social, political and economic priorities to serve the good health of all. In recent history, we have organized society for the sake of the power and privilege of a few “royal” families, to wage total war, and to maximize shareholder wealth. Perhaps, now is the time to organize society for the sake of the good health of as many people as possible.