The 1-2-3 of Healthcare

I am one of the many faces of the recent and current healthcare and financial crisis. It all began when I became ill after having lost my health insurance. I ended up going into major debt paying for my own care, which led to financial ruin and near-homeless. I experienced first-hand the profound tetra-enmeshed nature of the healthcare and financial crisis in our country…feeling and perceiving loss, isolation, and pain on the physical, emotional, communal, and systemic levels of experience. During this whole process I felt a strange kind of connection between the inner and the outer as my own personal health and financial crisis appeared to be reflected in the greater culture and society. I could not help but feel that this was all part of a tetra-evolutionary process. On the individual level, besides my outer physical healing work throughout all this, I have also been attempting to process this whole experience on the using various inner Integral Life Practices, including Shadow work to uncover my own personal Shadow patterns that contributed to this situation. Concurrent with this individual inner-outer work, I have also been attempting to reflect on the collective and social dimensions of my experience by exploring the current healthcare debate from an Integral perspective, using various Integral lenses.

Looking at the issue from Integral Theory’s Big Three of I-We-It or 1st-2nd-3rd Person dimension-perspectives, it seems to me that within the boiling healthcare debate-soup there are 1st Person (1p), 2nd Person (2p), and 3rd Person (3p) competing healthcare reform approaches:
  • Individual-Freedom-oriented (1p) free-market “private” healthcare approaches;
  • Social-Systemic-oriented (3p) government-run “public” healthcare approaches; and
  • Collective-Community-oriented (2p) co-operative/non-profit “semi-public/private” healthcare approaches.

The private (1p) approaches appear to be most heavily associated with the conservative and mythic value meme (vMeme) political camps; The semi-public/private (2p) approaches associated with the centrist and rational vMeme political camps; and public (3p) approaches associated with the progressive and pluralistic vMeme political camps. In between these centers-of-gravity there appears to be varying degrees of attempted integration from those who are on the borders (between mythic/rational and rational/pluralistic vMemes).

Within this debate there also appears to be a fundamental question of whether healthcare is an “inalienable right” or “a privilege.” I believe this question is rooted in the central duality of our country’s doctrines which attempt to include equal measures of individual freedoms and certain socially-protected “inalienable” equal rights. Many of the 1p or private approaches to healthcare appear to champion freedom (individual and market) while forsaking some level of equality (degree of healthcare depends on economic class) and inalienable rights (degree of health is often directly related to an individual’s capacity to pursue the inalienable rights of Life, Liberty, and Happiness). Alternatively, many of the 3p or public healthcare approaches appear to sacrifice some degree of freedom (individual and market) in exchange for healthcare equality and inalienable rights, and most of the 2p or semi-public/private approaches seem to sacrifice some degree of both freedom and equality.

Then we have the issues of cost and quality. The private (1p) healthcare approaches tend to cost more for the individual person or group directly and cost less in taxation, while offering a relatively high degree of quality for those who can afford it and often a poor degree of quality for those who cannot afford it. The public (3p) approaches appear to cost the individual or group less in direct costs and more in taxation, while offering a more moderate degree of quality to a greater and more equal population. The semi-public/private (2p) approaches generally seem to offer a moderate degree of both cost and quality.

I believe this type of public/private/semi- (1p-2p-3p) tension can also be observed in our approaches to education. While our system is far from perfect, we seem to have achieved some degree of integration between the three perspectives by simultaneously offering public (3p) education, private (1p) education, and semi- public/private (2p) education (charter schools, home-schooling, etc). I think education is a good correlation to healthcare because both education and health affect an individual’s ability to pursue the inalienable rights of Life, Liberty, and Happiness.

In light of our country’s dual aspiration of individual freedom and socially-protected inalienable equal rights, I believe that a 100% private or a 100% public healthcare system is untenable and fundamentally incongruent with the aspirations and doctrines of our republic. While the nuts and bolts of our education system still needs a lot of work, I believe the 3-tiered structure that has evolved is inherently natural to our country’s ideals and current vMeme structures. Using this model, here is one possible scenario for an Integral “Big Three” approach to healthcare reform…

Basic Healthcare System Design:
  • Public Healthcare: Expansion of Medicaid and Medicare into a full-blown public healthcare system for those who cannot afford private care.
  • Private Healthcare: Strike a healthy balance of regulation and freedom for the Private Healthcare system (i.e.: Stronger patient rights; allow competition across state-lines; insurance pooling system; and balanced tort-reform).
  • Semi-Public/Private Healthcare: Regulatory support and incentives for Cooperative, Charter, and Non-Profit healthcare groups.

Obviously within this kind of three-tiered (1p-2p-3p) system there are a lot of complicated details that would have to be worked out, but I do believe a more Integral approach, like the basic template of the above three perspectives and the inherent dual aspirations of our system, can help a great deal. For example, with this awareness in mind, it seems to me that the notion of requiring all citizens to buy health insurance may go against the individual freedoms doctrines of our country. Interestingly, it seems that with the above proposed three-tier healthcare system, this requirement would be unnecessary, since the public system would be a free system for those who cannot afford private or semi-private/public healthcare.

So here it is…my own personal attempt to jump into the healthcare debate. I toss these words into the healthcare tetra-evolutionary soup with my prayers for vertical transformation for myself, for those in similar and worse situations, and for the greater system in which we live and co-create and co-evolve…

*Originally published at Integral Life

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