To me, what ends up mattering in a lot of situations is not what is real but what people believe is real. If someone is walking around thinking that the way our species will go on and prosper is if the strong members succeed over the weak, that’s a powerful ideology. Considering that evolution is the main ideology perpetrated in “higher education” as the way life works, having a doctor think, even subconsciously, that someone who is weak in any way is not going to help our species evolve, I would think he would be less inclined to try to help that person.
Our society is a strictly structured hierarchy. It would be hard to argue against there being a gaping separation between the top 5% of our society in terms of wealth and the lower 95% who don’t even come close to having that kind of power. If someone in that top percentile went to a doctor for a problem, how would they be treated? Why? Would their personal doctor see them for just a couple minutes, diagnose them based on a brief account of their symptoms, then hand them some samples the local drug rep gave them earlier that week and send them on their way? Or would that doctor bust their ass to make sure that politician/heiress/top business executive received the best treatment available because they were seen as important and could buy the best care, if they have to pay for it at all?
Maybe all doctors make some attempt to help all those in need of their skill. Or I would like to think they do. But I remember my grandfather complaining bitterly at the end of his life, where he was a family doctor into his 80s, that doctors have a quota in terms of the number of patients they have to see each day. This results in the doctors only being able to see patients for around 15 minutes, regardless of the care they need. If not, the insurance companies will not pay the doctor for the extra time. Since most people in America depend on health insurance for their medical needs, if they’re able to even afford it, this severely limits the kind of care they will receive.
When I think of what it means to be a doctor now, in this country, I feel sorry for them. They have been reduced to drug distributors. They are dealing with a crushing amount of debt from medical school, commonly in excess of $150,000 dollars. They are under constant assault from the advertising monster that is the pharmaceutical industry, with well groomed articulate drug reps buying their office lunch on a weekly basis just for five minutes of the doctor’s time to give them a sales pitch and drug samples.
I know of very few people who do not go to the doctor on a regular basis for one problem or another, so there is no shortage of customers. If people don’t like the treatment they receive from one doctor or another, who can they turn to? With a demanding work week, family, bills, car problems, etc, trying to get a second or third opinion can seem like a nice idea but not practical. Without enough time for a doctor to begin to get to know their patient on a more personal level so that the whole person can be healed, how can they provide quality care? People are lucky sometimes to get any medical attention at all, and a lot of the times it’s a matter of luck whether their body does not have a serious adverse reaction to the medication they were given.
So what of these people who can not afford top medical care? Did they just have the horrible luck of not being born rich? In a society that seems to pride itself on anyone being able to make it in this world if they try hard enough, you don’t see that happen a lot. But it is the people who come from families already well off and connected to powerful people that have access to the best care money can buy. Is that because they are better? Is it because they have proven themselves more valuable to society? Or is it just luck?
If it is luck, then it becomes harder to justify not giving everyone equal quality of medical treatment. In the end, it is the people who can afford the best treatment available who will get it. Who would dare brush those people off? They are the ones leading our society to a better tomorrow, they better get good medical care. They were born rich and powerful, so obviously evolution has smiled on their family. Why shouldn’t the medical establishment do the same? If you are poor, obviously you have done something wrong. You had the chance to succeed in school but didn’t. You had the chance to bust your ass at a job and work your way up. You had the chance to buy nice clothes that gave you the confidence needed to succeed in social settings and procure a mate worthy of advancing the species.
Oh, wait. Never mind. You were born poor. Evolution has already decided your fate, and the rest of society will just follow suit in treating you with the same respect. Enjoy your life and just hope you don’t get sick, because if you do, you will be at the mercy of a medical establishment whose quality of care is decided by what you can afford. Your job determines the kind of insurance available to you, so you better hope it’s a good one. Even then, there are no guarantees you won’t die from congestive heart failure because your doctor was in a hurry and didn’t check to make sure the two medication samples he just gave you don’t have conflicting side effects. So much for the Hippocratic oath.
