Editor,
Mark Erasmus erroneously believes if people are denied universal health care, they will probably adhere to healthy lifestyles. Right-wing politicians in other countries echoed this attitude before those states initiated universal health care.
The New York City Public Health Association coordinated a study a few years ago focusing on other countries' universal health care systems and discovered poor people heavily utilized the free health services at first, but the numbers decreased as their health status improved, indicating they probably had been following wise health behaviors before these services were available and their wellness depended on more than just healthy behavior.
Also, Erasmus fails to realize that many chronic conditions and serious acute health crises in this country are not avoidable by simply following a healthy lifestyle. Moreover, the simple-minded approach that people are entirely responsible for their own health misfortunes is problematic since there is no clear agreement on what constitutes a healthy lifestyle. Smoking and alcohol abuse should be avoided, but experts disagree on how much exercise should be required or what constitutes a safe nitrate, lipid and carbohydrate intake.
The argument of denying free-of-charge health services will force people to take responsibility for their health fails to acknowledge much of our health status is determined by prenatal and early childhood health services, by social status, ethnic background, economics, gender, politics and the environment.
One example is race. In 2003, 20 percent of African-Americans, 33 percent of Hispanics and 19 percent of Asian Americans were without health insurance compared to 11 percent of Anglos. Those who were able to obtain Medicaid benefits spent more than three times as much of their income on out-of-pocket health care costs than did middle-class adults with private health insurance, and as a result, Medicaid beneficiaries experienced less medical care than middle- and upper-middle class insured people.
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According to Erasmus' logic, these uninsured people should be experiencing wellness. Yet the age-adjusted death rate for African-Americans was higher than that of whites by 41 percent for stroke, 30 percent for heart disease, 25 percent for cancer and more than 750 percent for HIV disease.
As a health promoter, I believe all Americans should have access to universal health care and preventive services. This program would not only focus on treatment, but include health promotion projects that encourage healthy lifestyles.
Studies show that most people desire illness avoidance, even when quick treatments are available. When they encounter comprehensive health education programs, they tend to improve their lifestyles. Denying people important health care services is inhumane.
Erasmus may have a problem with the collective good, but the moral test of a democratic society is how it treats the sick, children, aged people, needy and humans in general.
Larry Semark
UNM alumnus
