This is the story of the US Healthcare System. Born from the Judeo-Christian mission of caring for the ill, this system was educated through a series of parochial and public opinions and theories. In addition, as new science birthed new medical and nursing practices, Healthcare tried to accommodate new demands and higher costs. When it went through the inevitable adolescent stages, this System kicked and screamed to try to relieve itself of parental pressures from the past and it invented HMO’s, complex insurance policies, and, most of all, cash incentives to provide a kind of luxurious lifestyle of technologies, pharmaceuticals, and surgeries.

Without going into what midlife looked like, it is clear that the US Healthcare System is now suffering from a terminal disease. Its lifestyle has been indulgent; it has been gambling with its own as well as the lives of others; it has serious heart disease and suffers from drug overdose on a regular basis. In addition, it has a degenerative condition that is most expensive to treat, has no cure and paralyzes its ability to function.

Since neither the US Health System nor we are ready to give up, how do we administer palliative care to a terminal Healthcare System that refuses to die? How do we ease the pain of systemic and faulty assumptions? I feel like we are hanging on to an understanding of healthcare that is on life-support. The idea that we are each at risk of not being able to receive the medical care we need when and if we need it is unbearable. If we have insurance, if we work hard, if live our life is on a foundation of personal responsibility, how is it possible that we could still be among the few percent who will not receive healthcare benefits even if the current healthcare reform bill is passed?

I find the reports and dialogue equally disturbing because it seems that no one wants to really own their own risk in the current system. The uninsured are talked about as if we are not them. The underinsured are talked about as if they are just unlucky. And the insured are holding on to what they think is an unconditional lifetime guarantee.

So if we delivered narcotics to the Healthcare System that is now decaying in front of us, what would happen? Did Healthcare sign a living will? Did it put its assets into an irrevocable trust? Do we put it on a ventilator even if it is brain dead? Does anyone really care about what happens to this Healthcare System other than its beneficiaries?

When it comes to what any of us inherit from this dying and broken System, at best, is a somewhat loose promise that if we really get sick we will get what we need.

I am becoming more exhausted behind this discussion. It is plaguing my own heart to know that it is somehow acceptable that some man, woman, or child will not receive the care that they need when they need it. It is painful to think that the care will come only when it is an emergency and not when earlier treatment could prevent pain, suffering, and even death. Why is the acceptable?