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Letters


The right to health care cannot easily be divided from its funding, and the funding cannot easily be divided from fiscal oversight, even when such oversight is intrusive.


Indivisible questions arise


When I was serving as vice speaker and speaker of the Texas Medical Associa- tion House of Delegates, it was my job to determine if a resolution with two or more parts could be divided and voted on separately. Occasionally, there would be a re-


quest from the floor to “divide the ques- tion.” That is always honored unless the parts are inextricably connected, such as approving an action and approving the funding for that action.


Changes in public opinion and health


policy are creating indivisible questions that were once divisible. Whether appro- priate or not, in many arenas health care is now considered to be a “right.” Unlike rights such as life, liberty, and pursuit of happiness, this right must be created by funding or by confiscation of the service from the providers. Taxpayers have funded health care for longer than the entire career of almost


everyone currently in practice, at the lo- cal (hospital district), state (Medicaid), and federal (Medicare) level, and tax- payers heretofore have been somewhat restrained in dictating how health care is delivered. However, with the rise in the cost of health care, there are new attempts to assert control by both the financier (taxpayer) and its agent (government) in areas that were previously considered privileged. Thus, we have already had consider-


ation of laws in parts of the country to demand an ultrasound before an abor- tion, to require HIV testing in laboring mothers who have no previous prenatal care, and to dictate how large a serving of soda can be sold.


As the publicly funded portion of


health care enlarges, and certainly as it becomes a right, we can expect these assertions to become more frequent and more robust. We should anticipate possible further attempts to regulate


January 2013 TEXAS MEDICINE 7


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