Is healthcare a right, or a privilege?

I say it's a right. I think in a society like ours where there is so much prosperity that we have no other moral choice but to spread the wealth around and deliver a decent, basic, minimum amount of healthcare to everyone in our community.

Do you agree or disagree? Let me know. Zap me a note via the comments link at the bottom of this post. Or email me:

grant@yackon.com

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I know what you're thinking. We can't afford it.

But we can. How can I say that? Because I know the dirty little secret about health care on Nantucket: the way we deliver health care now, to both insured and uninsured people, is grossly inefficient. And not at all cost effective.

Here's the thing. We provide healthcare to town employees, but it's not working. Why? Because it's hugely expensive and the cost is increasing by 6-7% a year. That means that in less than a decade, we could double the cost of delivering healthcare to town employees — the largest class of workers on island. We simply cannot afford to continue on that path.

Here's the other thing. A massive portion of our workforce is uninsured. As a result, they do not get preventative care, and end up using the emergency room like a doctor's office, only coming in when they have a real problem. Many require costly emergency treatment. Many can't pay. The hospital, by law, cannot turn them away, so they end up footing the bill.

look at this example: A 55-year-old carpenter comes into the emergency room with a severe stroke and requires rehab and long term care in our island home for the rest of his life. Now rewind the clock. Had his high blood pressure been checked all along and had he received inexpensive anti-hypertensive medication, he could have avoided the stroke, prolonged his life, improved his productivity and saved the hospital and the community hundreds of thousands of dollars. Perhaps millions.

Why didn't he get preventative care? Because he was uninsured and doctors visits without insurance are expensive. So he went without. Now can you see how a change in the way we deliver healthcare can actually save us money instead of costing us money?

How can we deliver healthcare to the community in a more effective way? Well, I will not sit here and tell you that I have all the answers. But I do know how to get there. We need to establish a Healthcare Commission. And we need to appoint five members of the community with the brainpower, the financial and insurance expertise and the knowledge of health care delivery to create a program for this island.

We have a water commission to ensure we are delivering clean water to the community. We have an airport commission that delivers exceptional transportation benefits to us. Both run like businesses. Both have balance sheets and enterprise funds. That same model can be used to deliver another basic right — health care.

Many people believe we need huge insurance companies with massive networks of providers. But we don't, really. We can take charge of our healthcare destiny as a community.

It's doable. In fact, it's been done. In Ithaca New York. Click here. The Ithaca Healthcare Alliance has been in existence since 1997. And they offer a kit to show other communities how to do what they have already done. I'd say that's a good place to start.

The Vineyard is also taking similar strides. Click here.

Nantucket is a different kind of place, so we may need a different kind of solution. We need to look at every aspect of our healthcare situation. We need to put the best brains in our community to work on it. For the sake of everyone's health.

Let me know what you think.