Privilege in Health

There are two trees: one from countless hours of stained glass artwork planted into the side of a massive hospital, and one from decades of growth planted next to a single-story open-air school. Both represent life, direction, and hope.

The former tree, full of color and detail, represents Hospital Clínica Bíblica, a renowned private hospital in San Jose, Costa Rica. Clínica Bíblica has private rooms and all of the modern amenities associated with a hotel. It's a relatively expensive alternative to the public hospital down the street, but offers less waiting time and modernized technology.

The latter tree, tall and green, stands above a small rural school in Pacayita, Nicaragua. The Ceiba tree has been growing for generations, and marks a meeting place for community members according to locals: an iconic landmark. Its height conveys a sense of overwhelming grandeur; its trunk conveys a sense of majesty. The school that sits beneath the tree sprawls between two buildings, blue and white, with desk-chairs and chalkboards but not much else. We saw the tree as we approached, and were protected by it as we worked. We came to Pacayita as a mobile health clinic, bringing primary care to the small community without consistent access.

           

The range of health care services in the world is noteworthy, and perhaps alarming. The vast variety is striking: the clear, plastic bag with a handwritten pharmaceutical label from a wooden desk to the brand-name drug of a pharmaceutical technician in a sterilized white lab coat. The discrepancies in technology, in resources, in access to care, cannot be missed.

I think we have to start looking at health care as less of a commodity, less of a market-driven good that is purchased and sold, less of a system, less of a research project, less of the cafeteria or location of service. Less of a privilege. We need to start looking at health care as a right.

Privilege skews the odds. With privilege, with the luxury of a beautiful stained-glass tree, we have access; we have resources. With less privilege, with the beautiful shade of a Ceiba tree, we have limited access, limited time. Without either tree, we lack the very hope embodied in both. We lack the ability to make the decision for biomedical health care.

Because it's true, health care services should be a choice, and a right. We should feel empowered enough to choose to go to the clinic, to choose among health services. Where is that choice? Where is that right?

Anna