Texas Tech University Health Sciences Center
Health Care Access: A Right or a Privilege?

Health Care Access: A Right or a Privilege?

I am an accountant. Well, let me restate that. I have an undergraduate degree in accounting. There is a big difference. For the last 39 years, I’ve actually made my living as a healthcare administrator. I do get to use my accounting knowledge almost every day. At Texas Tech University Health Sciences Center School of Medicine, we use fund accounting, as do many governmental agencies. In this method, we often talk about encumbrances, which, as you probably know, is a restriction placed on the use of funds. The idea of an encumbrance is to ensure that sufficient cash will be available to pay for specific obligations. A broader definition outside of accounting would be to impede or hamper a function or activity. For example, I traveled to Kansas City recently with some extra luggage to deliver to a relative. I could say the extra packages encumbered me (although they really didn’t, and I was glad to do a favor for my sweet mother-in-law.).

Here’s where I am going with this little essay. Back in 1969, (yes, I know, I’m showing my age) The Hollies had a worldwide hit song, “He Ain’t Heavy, He’s My Brother.” The ballad, written by Bobby Scott and Bob Russell, also became a big hit for Neil Diamond the following year. It’s a beautiful song with a wonderful message. Go to YouTube and listen to The Hollies’ version. In the song, it talks about the difficulties of life and that we never quite know where we are going. But, that the person singing is strong. Strong enough to carry his brother. Why? Because his brother’s welfare is his concern. And, BTW, (he says) his brother is not heavy because, well, he’s his brother.

My favorite lines in the song are these:

We’ll get there
For I know
He would not encumber me
He ain’t heavy, he’s my brother 

There is that word, encumber! I want to relate this song to health care. At the essence of every health care debate in the United States is this question: Is health care a right or a privilege? This is also characterized as market justice vs. social justice—should health care be treated as any other market good (like clothes or housing or cars), or is it a social responsibility? Thanksgiving is coming up. Maybe this is a good time for each of us to consider the question and to form our own opinion. Do we want to see that everybody has access to health care (i.e., it is a right), or do we view taking care of someone else as an encumbrance and that individual’s personal responsibility? I am not suggesting you view the matter in a certain way. I am saying it is something to think about.