by Elizabeth Skoglund
As children many of us became familiar with the Aesop fable about the goose that laid the golden egg. A man and his wife owned this very special goose who morning by morning deposited a golden egg at their feet. From it the couple grew very rich.
But then one day they got a brilliant idea. Why not kill the goose and take out all of her eggs at once? That way they would be even more rich. Once the goose was killed, however, came the shocking reality. Not only had they killed the good for the perfect, but in so doing they had lost the good. There were no more golden eggs. And now there was no goose to lay a golden egg tomorrow.
We in the United States have a healthcare system which is probably the best in the world. Flawed, yes. But still the best. The greatest test of its efficiency lies in the fact that when people in other countries need special medical care they still try to come here, even when they can afford to go anywhere in the world.
Let’s keep the golden goose, feed her better, change her environment a little, but not kill her in order to get something we think might be better. We may end up with simply a dead goose, a failed healthcare system.
Various statistics indicate that many people are contented with their healthcare. We don’t hear about them too often. However, there are definite problems inherent in the system: those who are uninsured or under-insured; those with pre-existing conditions who are therefore denied insurance; and those who for one reason or another do not receive quality care, to name a few.
It is important, however, to understand the real issues relating to healthcare and not just be taken in by the rhetoric. The people of pre-World War II Germany did not possess any unique bent toward evil. But they had been subjected to many years of brainwashing by power-hungry leaders. The use of words slowly eroded morality and enabled evil to be dramatically unleashed.
Psychiatrist Viktor Frankl, a concentration camp survivor himself and a man with unusual insight into the Holocaust, wrote:
I am absolutely convinced that the gas chambers of Auschwitz, Treblinka, and Maidanek were ultimately prepared not in some ministry or other in Berlin, but rather at the desks and in the lecture halls of nihilistic scientists and philosophers.1
In the late nineteenth century, Friedrich Neitzsche’s philosophy and composer Richard Wagner’s prejudices laid the cultural groundwork for the Holocaust. Hitler was deeply influenced by both men; it is said that he often listened to Wagner’s music while making major military decisions.
In his masterpiece on the Third Reich, William Shirer wrote:
I think no one who lived in the Third Reich could have failed to be impressed by Nietzsche’s influence on it. His books might be full, as Santayana said, of “genial imbecility” and “boyish blasphemies.” Yet, Nazi scribblers never tired of extolling him. Hitler often visited the Nietzsche museum in Weimar and publicized his veneration for the philosopher by posing for photographs of himself staring in rapture at the bust of the great man….
Finally, there was Nietzsche’s prophecy of the coming elite who would rule the world and from whom the superman would spring. In The Will to Power, he exclaims: “A daring and ruler race is building itself up…The aim should be to prepare a transvaluation of values for a particularly strong kind of man, most highly gifted in intellect and will. This man and the elite around him will become the ‘lords of the earth.’”
Such rantings from one of Germany’s most original minds must have struck a responsive chord in Hitler’s littered mind. At any rate he appropriated them for his own – not only the thoughts but the philosopher’s penchant for grotesque exaggeration, and often his very words. “Lords of the Earth” is a familiar expression in Mein Kampf. That in the end Hitler considered himself the superman of Nietzsche’s prophecy cannot be doubted…
“Whoever wants to understand National Socialist Germany must know Wagner,” Hitler used to say.”2
The facts of our current healthcare system do not support a nihilistic approach, a tearing down of the old and rebuilding something totally new – killing the golden goose! Based on the 2007 census data, 45.7 million people in the United States are uninsured; 13.4% are native-born citizens, while 43.6% are non-citizen immigrants. To address the issue of illegal immigrants first, while I believe that it is morally imperative for everyone on U.S. soil to receive medical care, if illegals were forced to obey immigration/citizenship laws then there would be a large decrease in the demands on an already overburdened healthcare system. That would be major reform for both the economy and the availability of healthcare.
Having come from an immigrant family, I remember first-hand the stories of hardship and anxiety they went through. Obtaining money for the journey; passing health tests in order to be a legal immigrant; leaving loved ones behind, knowing that because of the distance involved and because travel was less common in the early 1900’s they might never see their family again. Then there was the struggle for jobs, housing and just survival. They waited and then worked hard and made it. They did not have a sense of entitlement about anything, including healthcare, but, of course, as they became absorbed into American life they shared in such benefits.
Many illegal immigrants here today have also worked hard and contributed to American life. But they entered through the wrong door of illegality. Just because illegal status has become a prolonged state does not mean it becomes okay. Yet, I would agree, that perhaps some equitable plan could be worked out for those who in every other way have been an asset to this country. Others who are not in that position but have become a drain on our resources should be required to start in their own country in making application to come to the United States.
For those who are already legal inhabitants of the United States, whether immigrants or not, a requirement to obtain healthcare insurance should perhaps be put into effect, similar to the requirement for mandatory drivers’ insurance. This would eliminate the burden on emergency rooms by people who are young enough to feel invincible (“I’ll never get sick enough to need medical care”) and those young enough or stupid enough to prefer to spend their money on something other than medical insurance. This alone would have a positive impact on the economy as well as on the quality of healthcare.3
For those too poor to buy insurance, or not qualified because of preexisting conditions, governmental help could appropriately intervene. Let us be aware, however, that some such programs which already exist, such as Medicaid and the State Children’s Health Insurance Program (SCHIP) are not always utilized or even enrolled in by those who need it. If insurance were mandatory, these programs might become more widely used. It is also possible that improvement within these programs would make them more appealing.
If it has not already been done, the amount of monetary savings from the above changes would be important to evaluate. Then, with the money saved, some positive changes could be made to improve care, rather than trying to save money by dumbing down the quality of government programs, like Medicare, Medicaid, and SCHIP. Cutting costs unfairly, so that competent medical care is not available, is not an answer to our healthcare problems. Doctors will refuse people in these programs, forcing patients to accept inferior care and eroding the patients’ right to choose. Making sure we care for our own citizens and requiring personal responsibility from these citizens through mandating insurance coverage should help both the cost and quality of medical care. Rationing healthcare is not an answer, nor is healthcare without choice.
As individuals we must be vigilant in informing ourselves and others about the massive changes which are being considered – and we must continue to be vigilant since changes may not come all at once but rather increment by increment over the next few years. A slow decline could bring us to a point which we never expected could happen. Before 1930 the German people may never have dreamed that a mentally retarded child, their own child perhaps, could have been euthanized as a “defective,” as a “useless eater,” as “life unworthy of life.” “But they were euthanized. For in 1920 a jurist Karl Binding and a neurologist Alfred Hache published The Permission to Destroy Life Unworthy of Life which promoted euthanasia for those with incurable physical or mental illness and for the severely retarded. The Journal of the American Medical Association reviewed the book in that same year. The book claimed cost as one reason for euthanasia and left the ultimate decision up to the state or physician. At this point, endorsed by Hitler, the concept of “life unworthy of life” was introduced to the German people. The book was well accepted. In the words of the late Paul Ramsey, a medical ethicist, “Remote possibilities are soon proximate, and soon done.”
Imagine a family of five – a mother and father, two children, and Uncle Joe, who is getting on in years and has therefore moved in with the family after the death of his wife.
When he first joined the family, Uncle Joe was fast living and hard drinking, but so full of wit and good humor that no one minded his shortcomings. When he was drunk, he went to sleep. Besides, he worked hard during the day, made a good salary, and contributed generously to the family’s support.
Times are changing, however. The family needs the money less now. With the father’s salary increases and the mother’s new job, life has become relatively easy. More than that, Uncle Joe has ceased to be fun. Rather than sleeping off his drinking bouts, he shouts and demands. Furthermore, he is moving toward retirement age, and no one relishes the idea of having him home all the time. The children are older now, and they want separate bedrooms. The mother is tired of cleaning up after him.
And then Uncle Joe has a stroke, leaving him partially paralyzed and unable to speak.
Uncle Joe has changed. The family has changed. And nobody wants Uncle Joe around anymore.
A nursing home is not an option. The government no longer pays for that. And it seems a shame to waste Uncle Joe’s life savings when his quality of life is so poor anyway. Uncle Joe, as they had known him, wouldn’t want that! Furthermore, the children need that extra money for college.
One day the father asks Uncle Joe to go with him to the doctor’s office for a flu shot. While Uncle Joe sits in his wheelchair, and turns pages in old magazines in the waiting room, the father has a brief consultation with the doctor regarding the old man’s health and state of mind. A few papers are signed, and Uncle Joe bares his arm for his shot. Then the father returns home, alone.
It wouldn’t be that hard to do, with the right mind-set. After all, why doom a nice man like Uncle Joe to an alcoholic’s death? Didn’t we do as much for the family dog last year?
When this happens the impossible will have become possible. Fiction will have become fact. The golden goose will be gone forever.
- Viktor E. Frankl, M.D., The Doctor and the Soul (New York: Random House, Vintage, 1973), xxi.
- William L. Shirer, The Rise and Fall of the Third Reich (New York: Simon and Schuster, 1959), 100.
- Regarding this suggestion and the several following, we would prefer a private solution, especially early Christian America’s practice of forming voluntary associations—the Isaiah 58 and Ephesians 4:12 work of the ministry—for every social need. Possible civil remediation would include tort reform—a return to sanity in the civil courts. Other non-statist solutions have been offered.—NPI Ed.
© 2009 by Elizabeth R. Skoglund. Used by permission.