The moral implications of health-care reform.  My column in today’s Greenville News.

How many health-care dollars would we save if children were all born within the confines of marriage? If their biological fathers were fathers in every sense? Evidence suggests that children with fathers involved in the home, in intact families, are not only economically more secure but healthier, safer and experience greater educational success.

And how many health-care dollars would we save if men and women did not have serial sexual partners, did not contract and spread the many sexual transmitted infections that plague the country? We would certainly reduce the amount of money spent on antibiotics and pain medication, as well as the dollars spent on life-extending therapies for HIV and hepatitis. And since our national sexual mores have other unintended consequences, like scarred fallopian tubes in young women, we would ultimately need less money for infertility treatments…and counseling.

Try and conceive a world in which humans treated one another in a way that reinforced their intrinsic value, and circumvented the standard-issue loneliness that leads to depression; and fiscally speaking, to so many anti-depressants.

How many health-care dollars would we save without trauma centers facing endless waves of patients who have been assaulted physically or sexually; patients injured by drunk drivers and gang-shootings; patients dying from the many side-effects of illegal and prescription drug abuse?

I wonder how much we would save if individuals were less keen to threaten litigation for every medical error (real or perceived) and if atttorneys did not encourage them? Because I can guarantee that less tests would be ordered and less unnecessary drugs administered. Sadly, I also wonder how much we would save if doctors were sufficiently concerned about the real benefits of expensive but scientifically unfounded medications and procedures.

I can’t imagine the cost-savings if persons with false-disability claims decided to go back to work and save the benefits for those who truly needed them. In my experience, the savings would be astronomical.

How many dollars would we save if families were empowered and emboldened to care for their aging loved ones at home, in comfortable, familiar surroundings, rather than in the state-funded senior farms which so many nursing homes have become? And what if no one insisted on exhorbitant care for their aged loved ones who were literally on death’s door, but saved it for those who would benefit?

These are just a few of the things that make our health-care culture so expensive. These are also just a few examples of areas where we might improve health-care costs through a comprehensive sense of morality. Now, someone is already call me a right-wing, Bible thumping moralist. But whatever I am, the fact remains that our newborn health-care reform was driven, allegedly, by a moral imperative.

The message we hear, over and over, is that providing health-care to all is the moral thing to do. President Obama referred to it as a ‘core ethical and moral oblication,’ and referred obliquely to the Book of Genesis when he said, ‘I am my brother’s keeper, I am my sister’s keeper.’ It is remarkable that so many who eschew the appearance of religion in public life were willing to call upon religious sources, directly or indirectly, to encourage passage of this legislation.

We have been told that the provision of health care is the very highest moral good. And it is good. But it is only part of ‘the good.’ In making it the highest national moral, we are observing a dismembered morality; a shattered morality. Much of what troubles our country’s health-care system could be fixed by a re-ordered, intact morality rather than one which honors only one small part of the greater picture; something which resembles treating a fracture in an already severed hand.

Do we wish to reform health-care for moral reasons? I understand the point and I agree; even if I disagree in technique. It really seems appropriate, since the practice of medicine has long been considered a moral act. But for reform to work, it must be accompanied by a greater, more pervasive morality, extending far beyond the mere provision of medicines and surgeries.

Moral lessons aren’t usually pleasant, as evidenced by the endless mantra ‘you can’t legislate morality!’ However, it seems the health-care reform legislation buries that old bit of wisdom in thousands of pages of rules, based in large part on morality. So maybe it’s high time for a big dose of ‘moralizing.’ If for no other reason than health-care reform.

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