Las Vegas Sun

March 28, 2024

Where I Stand:

Bottom line in the health care debate is the people

The problem with health care isn’t about politics. It is about people.

I realize that the country’s fascination with a businessman as president was enough to carry the day last year for Donald Trump. For a thousand different reasons, I opposed Trump’s candidacy. One was an insistence that I have maintained for decades that a businessman may not, by definition, be the best person for the job as commander in chief and leader of the free world.

Nowhere is that concern more compelling than when it comes to the issue of health care.

There is something compelling about the idea of a businessperson in the White House. People who run businesses learn to make decisions and, once made, are prepared to unmake them should circumstances warrant it. That happens every day and if it doesn’t happen, if flexibility and agility in the boardroom are not present, bankruptcies and financial losses would rule the day. There is a certain attractiveness to that idea especially when inaction and dysfunction seem to permeate the political climate these days.

My issue, though, has always been a bottom-line consideration.

The problem is that in business and in government there are two different bottom lines, and the current health care debate makes that difference crystal clear. In the business world, leaders are responsible for making a profit, and decision-making in that pursuit is oftentimes, to put it bluntly, brutal.

In government, that is promoting the general welfare and securing the blessings of liberty, the bottom line is not profit but people. And therein lies the conflict in the health care debate.

I have already expressed my opinion about the Affordable Care Act, Obamacare or Trumpcare — two of those are exactly the same although many people don’t know that. In short, it doesn’t matter much what they call it or how they do it. What matters is that all Americans have sufficient and affordable health insurance to provide for their health needs throughout their lives and in a way that doesn’t bankrupt them or their families should a major health catastrophe occur.

That health care idea requires government to provide for its bottom line — the American people. The conflict we are witnessing is that some lawmakers are worried more about the financial bottom line than the human net in this debate. And therein lies the challenge for a businessman. Which way to go?

I have witnessed the results of this debate recently in a most human way.

I know a man who worked his entire life. He gave to charity, he took care of his employees, he was a solid community citizen and he always tried to do the right thing.

And then he fell on hard times as did millions of Americans during the crash. And then he got sick!

The rest of his story has been one that is lived every day by thousands of people across this country. No family, no caretakers, no real assets to speak of and nowhere to turn for help other than whatever safety nets the state has erected.

The man is my friend, so I am trying to help. But what of those who are completely alone — who will help them? The bottom line of this story has yet to be written but the balance sheet is not good.

His insurance only partly covers his medical needs. One day he will run out of money to pay for the level of care he needs as he ages through life. The difference between facilities that can be paid for and those that exist for people with no means is stark and practically inhumane. Those for the very poor may be designed to do good but are operated more to warehouse people who are just waiting to die.

The people who work in these places want to do the right thing for their patients, but resources are short and bottom lines get in the way.

So the question comes down — as it often does — to what kind of country do we want to be? And that is where those who are committed to a bottom-line profit clash with those who believe the needs of our citizens should trump financial shortfalls.

This is not an easy question to resolve and I am sure Congress and the White House will argue about the answers for some time. But, in the meantime, my friend and many thousands just like him will suffer the indignities of the status quo until they no longer have to do so. And then there will be thousands more to take their place.

The health care debate should be about these people. But to some it is about everything but them.

P.S. The column above was written Thursday morning. When I finished I went to visit my friend at the rehabilitation hospital. We had a long talk about how he needed to get better and what we would do when he got his health back. How he would get back “in the game” of life and his life’s work. And then I left him. I had to get together with his doctors and plan his treatment. That isn’t an easy task when the docs have too many patients and not enough time for them.

And then I went home and went to sleep. I awoke Friday morning to the sad news that my friend, Bob Frank, had passed away during the night. After the initial shock came a sense of relief — for him, that he no longer had to deal with the indignities of growing older and sicker without family, friends or resources. For a man who at his prime was friendly with so many people in Las Vegas — when he did so much for so many — he died practically friendless and clearly forgotten.

His, sadly, is the story of so many tens of thousands who already have taken his place in line. Bob is the fortunate one. He got out early. He must have seen what was coming and willed a different ending to his life.

Rest in peace, friend Bob. Your passing and the way it happened means we who are left have a lot more work to do.

Brian Greenspun is editor, publisher and owner of the Sun.

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