So if you read the blog from a few days back on this site called,"Mountains Beyond Mountains," or read Tracy Kidder's book by the same name, you know the book digs deep into healthcare for the poorest of the poor in nations like Haiti, Peru and Russia. 

I loved the book because it really pressed my brain and made me think about my positions on healthcare in the U.S.  Long story short; here' this guy, Paul Farmer, an infectious disease Doctor with little government support, providing healthcare to the poor, and we are not talking "hand-me-down healthcare," to the poorest people on earth, without regard for their ability to pay, the quality of their insurance policy (ha! moot! what insurance?), or with handouts from the government.  

It is interesting as I think about the work of Partners in Health (the organization of Paul Farmer) and try to reconcile that with my own feelings about the distribution of healthcare.  My initial concern/feeling as I read the book was that I was on a very different playing field in my noggin' when it came to my positions on healthcare in the U.S. vs. those of an organization like PIH.

But I actually think we are very much in the same ballpark.  One of the greatest differences and struggles I have is around the mindset (or at least my perceived mindset of) of the American public, both its citizens and politicians compared to individuals in some of the poor countries PIH is addressing. 

In these poor nations where PIH is at work, the people in most dire need of healthcare view it as a privilege as opposed to an entitlement.  PIH views and provides healthcare as a right as opposed to an entitlement.  I believe this combination leads to greater accountability and willingness to get involved in the community of healthcare as well as in the betterment of the community overall.

In my mind there is a clear distinction between a right and an entitlement.  Primarily that one is a privilege that comes with accountability and responsibility and the other does not.  The Bill of Rights for example, proffers great privilege along with tremendous responsibility and accountability.

So many public programs, enacted as a means to help and assist, end up sucking our wallets dry, then wasting that money, often with sub-par results.  Think public schools for starters, Medicaid, other public healthcare programs, public housing, food stamps, and the list goes on and on.  Once folks get a taste of programs like these, oftentimes they believe the programs are their "right."  It's sort of a "money for nothing and chicks for free" kind of thing if you are a Dire Straits fan.

I think our politicians should take more time looking at programs like PIH when developing their own healthcare policies and structure them in a way such that those who receive the benefits are invested in programs that are not a gift, not an entitlement, but something for which they must invest in to the greater good and betterment of themselves, their families, their communities and society as a whole.

I think if we can change the mindset toward healthcare on every level, then we can correct many of the problems in the system, have a healthier nation and even better society overall.  Piece of cake.       

And yes, this does tie back to HSAs because those invested in them take on both responsibility and accountability for their personal and financial health and demonstrate tremendous responsibility in the process.