Why do we spend so much time discussing the color of the Band-Aid and so little time discussing the depth of the wound? (A metaphor: The wound is healthcare; the Band-Aid is health insurance.)

We discuss the details of competing health care plans from Republicans and Democrats, but we spend almost no time on the bigger discussion: Is healthcare a right in America – one that we’ve largely ignored?

Americans dance around this core question. The right can’t say, “No, it’s not a right,” because it sounds a lot like “Bah, humbug – I spit on the poor.” And the left can’t say, “Yes, it’s an inalienable right,” because there’s nothing in any religions or the U.S. Constitution that agrees. Most religions stress helping the poor, but full-fledged healthcare is a stretch.

The cold truth: Healthcare isn’t an inalienable right. Nothing is guaranteed in life – not food, not shelter, not healthcare, not even life itself. From Cain and Abel to slavery and the Holocaust, history is filled with people who lived their lives unfairly.

In the healthcare discussion, “right” really means: “It’s a value we the people believe our fellow citizens deserve.”

When men and women banded together in tribes eons ago, we agreed to defend each other. When we eventually formed really large groups based on geography, we formalized ways to work together, even if that formal way was a king at the top making all decisions. When we eventually tinkered with a new form of oversight, a democracy, it got more complicated.

Government – any form of government – is the very definition of herding cats.

Still, the core question when mastodons walked the earth is the same core question today: How much should we do for each other? Given finite resources, what must we do and, by default, what must we ignore?

The healthcare debate

Forget the political healthcare claptrap. Start at the core: Where does healthcare fall in that list of U.S. priorities? How does it stack up against, say, defense? Agree or disagree with Donald Trump’s budget that pushes gobs of money into defense and short changes healthcare and other altruistic things, the basic discussion is valid: Where do we invest limited resources?

Democrats hate this but know it’s true: Obamacare is a big hot mess. The uptick in coverage is a big step forward, but the funding mechanism via taxes is draconian, unfair to the middle class and understood by less than 1 percent of the population. The goals are noble, the rules convoluted.

We, as a group working together, have three options:

• Option 1: Kill Obamacare.
• Option 2: Improve Obamacare or replace it with something better.
• Option 3: Find some middle ground.

The option we pick depends on our healthcare philosophy – the value we the people place on healthcare for all.

If it’s not a right: Allow sick people to die in the street or, if they have some money, give it to doctors and, when it’s gone, take their house and boot them to the street. If other priorities come first – if only the rich can afford healthcare – then admit it out loud.

If it is a right: Go for universal healthcare. Make everyone pay a fair amount based on income and cover everything within reason. There would still be limits, but no one would be ignored.

If it’s somewhere in-between: Healthcare is expensive, and saying “We can’t afford that” isn’t a sin. If we can’t offer universal healthcare, start small – maybe a national plan that only covers once-per-year checkups and catastrophic events that destroy families. Allow private insurers to pick up the slack for Americans who can afford it.

Look at your family, your friends, your town. Assume that some people don’t have health insurance, and a doctor will tell one of them: “I’m sorry, it’s cancer.”

Now ask yourself what you believe: Is healthcare an American “right”?

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