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Health, Not Just Insurance

The shocking news of a shooting at a Sikh Temple in Oak Creek, Wisconsin will further eclipse the already receding news of the July 20 shooting at a theater in Aurora, Colorado. Yet as the headlines fade, the painful realities of recovery for the surviving victims of these mass shootings must continue, even as others seize on the tragedies to make political points.

Some Colo. Shooting Victims Have No Health Insurance,” blared an AP headline. Rep. Ed Perlmutter (D-Colo.), whose Congressional District includes much of Aurora, chose to highlight the positive role of the 2010 Affordable Care Act, aka Obamacare, in the healthcare future of the victims:

It will stop the discrimination against people with prior illnesses or injuries, or say some of the folks who were shot in the theater, they would be uninsurable now that they’ve had that wound, but under the affordable care act they can’t be discriminated against starting in 2014.

Perlmutter has a point. Most of the Colorado victims do, in fact, meet the demographic profile–young, working class–of the 45 million uninsured that Obamacare presumes to help. Yet it’s not clear that these particular patients will need the benefits of Obamacare, at least in the short run: “Hospitals waive fees, co-pay for Colorado shooting victims,” announced another AP headline.

In other words, the desire to be compassionate–a desire amplified in the modern television age–has already trumped the issue of who has insurance and who does not; in the electronic village, we are our brother’s keeper.

In fact, it seems that if a compassion case becomes famous enough these days, torrents of money come rolling in from “points of light.” That’s what happened to Karen Klein, the bullied school-bus monitor in upstate New York who has received more than $700,000 in spontaneous donations since her case went viral in July. Moreover, as a matter of federal law since 1986, we have been charged with keeping each other healthy in hospital emergencies, without regard for ability to pay.

In a sense, the whole health-insurance debate over the last 25 years has been hollow. One way or another, in our connected society, everybody is going to get treated–whether they have health insurance or not. The epic fight over the health-insurance “mandate” was a bit of a misdirection because when the crunch comes it doesn’t really matter whether people have a laminated card that has “health insurance” written on it; when the crunch comes, as in Colorado, they will be treated, card or no card. And in a world of cameras and bloggers, it will always be thus.

So the real question is not simply care, but rather the quality of that care. Happily, in the U.S., emergency-room medicine has improved dramatically. A 2002 study found that improvements in ER care over the previous 40 years had cut the death rate among assault victims by as much as 70 percent.

Much of this continuing rapid progress has been driven by military medicine. In World War II, for example, 30 percent of those injured in combat died from their wounds. By the time of the Vietnam War, that percentage had fallen to 24 percent, and today in Afghanistan it’s dropped to 10 percent. The military has always had medics and military hospitals; the key variable, of course–for service personnel on the battlefront and civilians on the home front–is what sort of technology can be applied.

And here we see that while we have made progress, we could make more progress. Let’s consider the sad case of 25-year-old Ashley Moser, one of the Colorado victims–shot a total of three times in the neck and abdomen. Moser, a single mother, seems to have been under- or unemployed; she was also struggling with student loan debt.

Yet the unfortunate woman’s worst problems are not financial. She lost her six-year-old daughter at the scene in the theater and then lost her unborn baby in a miscarriage a few days later. What further gains in trauma care could have saved those children? If we had been focusing on real medical science over the last two decades–as opposed to mostly symbolic health-insurance finance schemes–what miracles might have been achieved on behalf of Moser’s babies?

Meanwhile, Ashley Moser herself seems likely to be paralyzed. Her mother told yet an AP reporter that she hopes her daughter will at least be able to regain the use of her arms.

We might ask, on behalf of Moser, can’t we think bigger than that? Can’t we think about using our resources to help the woman walk again? It’s wonderful that compassionate people want to help her, but surely the greatest help of all would be to empower her to regain the full use of her legs.

We could ask the same questions on behalf of the hundreds of spinal-cord injury victims coming back from Afghanistan. The government and others are spending plenty of money to help our wounded warriors–and they have registered numerous successes–but are they spending enough? Are they spending it the right way? And most importantly, are they aiming at the full rehabilitation of the wounded?

Few higher-ups in official Washington know the answer to those questions because few in D.C. are really worried about the science of spinal cords and brains and the nervous system. Politicians are always ready for a photo op with a recovering soldier, but are they thinking hard about actually repairing the war-damage, as opposed to just financing it over the next four or five decades? If more were, we would know about it: we would see them on TV or the web, meeting with medical experts, talking up their vision for curing as opposed to caring. As we have seen, finance has eclipsed science, and so we have well-financed patients, as opposed to cured patients.

Yet the sad saga of seriously injured shooting victims–injured in Wisconsin, Colorado, and elsewhere at home, as well as those hurt in faraway war-fronts–should make us realize that the greatest healthcare compassion is maintaining and restoring health. Health insurance is important, but health itself is more important.

James P. Pinkerton is a contributor to the Fox News Channel and a TAC contributing editor. Follow him on Twitter.

about the author

James P. Pinkerton is a contributor to the Fox News Channel and a regular panelist on the Fox “News Watch” show, the highest-rated media-critique show on television. He is a former columnist for Newsday, and is the editor of SeriousMedicineStrategy.org. He has written for publications ranging from The Wall Street Journal, The New York Times, The Washington Post, The Los Angeles Times, USA Today, National Review, The New Republic, Foreign Affairs, Fortune, The Huffington Post, and The Jerusalem Post. He is the author of What Comes Next: The End of Big Government--and the New Paradigm Ahead (Hyperion: 1995). He worked in the White House domestic policy offices of Presidents Ronald Reagan and George H.W. Bush and in the 1980, 1984, 1988 and 1992 presidential campaigns. In 2008 he served as a senior adviser to the Mike Huckabee for President Campaign. Married to the former Elizabeth Dial, he is a graduate of Stanford University.

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