Dreaming of access for all to good health

While it is unfortunate, it is also true that like the poor, the sick will always be with us.  So helping to prevent sickness and treating it effectively when it does occur would seem to be proper concerns of civilized societies.  Or at least, one could be forgiven for reasonably believing so.

Health care reform is currently a pressing issue in the United States, as well it should be.  So long as insurance company administrators, instead of medical professionals, determine what health care should be provided to those who need it, the system there simply doesn't work as it should.  One would think that is a no-brainer. 

Having watched the antics on all sides for the past year, I am particularly unhappy with the behavior of those who clearly don't want to do anything to improve the situation.  They seem conveniently to find no conflict of interest in the fact that they are also receiving significant campaign contributions from the very health insurance companies that have abused the current situation.  They use a variety of scare tactics and shamelessly misuse terms.  In this, they are aided and abetted by several in the conventional media.  This is unforgivable, in my opinion.

I share the consternation of those on this side of The Pond, indeed of many in the US itself, who find the whole circus extraordinary.  What on earth has happened to logic in America?  Accessible and affordable health care is -- or should be -- a right for all citizens in a civilized society.  That is simply the bottom line.  The only question should be: how can accessible and affordable health care for all, or as many as possible, best be accomplished in the shortest possible time?  Any person or group that is putting obstacles in the way of this goal is quite simply reprehensible.  To say the least.

Perhaps we all need reminding of how health care institutions came to be -- at least in western cultures.  In medieval cultures, where the forerunners of today's hospitals began, hospitals were usually begun and managed by religious orders, or charitable individuals or leaders.   Many charitable individuals were moved by thoughts of their potential reception in the hereafter and decided to hedge their bets in that hereafter by doing good works while still here on earth.  Religious orders often performed such good works because they believed that "tending the sick" was a mandate of their faith.  Leaders were often the most immediately pragmatic.  After all, persons who were ill tended to infect others.  If everyone became ill, who would provide the practical skills for society to function ... and for commerce to flourish so that there would be money to pay taxes?  Whatever the initial motivation, the most successful systems were results of coordination and commitment among all concerned.

Within a few hours' drive of Geneva, there is one of the most unique, beautiful and successful examples of what developed in medieval times.  That is the Hôtel-Dieu of Beaune in Burgundy, France, literally an architectural jewel and a wonderful place to visit.

The Hôtel-Dieu was founded in 1443 by Nicolas Rolin, Chancellor to Duc Philippe le Bon of Burgundy, and Rolin's wife Guigone de Salins.  It was a time near the end of the Hundred Years' War when roving bands of marauders were still looting and pillaging, generally provoking even more misery and famine among the people.  Those who lived in Beaune and the surrounding area were for the most part destitute.  So M and Mme Rolin determined to create a hospital that would also serve as a refuge for the poor.

The hospital opened its doors in 1452, some 40 years before Christoper Columbus discovered America.  Elderly, disabled and sick people, orphans, women about to give birth and the destitute have all been uninterruptedly welcomed for treatment and refuge, from the Middle Ages until today, although no longer in the part housing the museum.  They were tended there by the Hospital Sisters of the Hôtel-Dieu.  Visitors today can view the Grand Hall, where the poor were tended, each in an individual bed with curtains.  The patients, except for those who were so clearly bedridden that they could not leave their beds, would eat at huge tables set up in the center of this hall.  While the tables are no longer there, there are explanations and depictions of what it looked like then, together with examples of utensils.   As part of the visit, one can also see the kitchen where meals were prepared.

For the poor in the area, this was unimaginable luxury and the care they received there was greatly appreciated, especially during various ravages of the plague.  Patients of greater means and members of the aristocracy were also accepted, but were expected to contribute towards their upkeep.  They thus had more luxurious trappings.  But no individual rated a private room.

Many donations -- farms, property, woods, works of art and of course vineyards --  were made to the Hôtel-Dieu, by grateful families and generous benefactors.  Because of its long tradition of caring for the poor, it was among the few properties that were spared the ravages of the French Revolution.  Bands of peasants destroyed properties belonging to aristocrats and the Church elsewhere in Burgundy because they were widely seen as symbols of oppression.  But both the Hôtel-Dieu and Beaune were seen as exceptions.

France today has a health care system that is widely seen as one of the most accessible and with the best quality of care in the world.  It is not without its problems, but it certainly is head and shoulders above the health care system in America insofar as universal and affordable access to care are concerned.  Don't let anyone tell you otherwise, because it simply isn't true.  Other systems that have emulated the French system are also ranked higher than our own.

Perhaps we simply needed a much earlier beginning.  But let us no longer waste time in doing whatever is necessary to move health care reform forward.  Please!