… the path of healing leads not back whence we have come, but
ahead, toward a new beginning.
Marc Ian Barasch1
As though we were traveling along a Möbius strip, we return to our starting point. Health care is about many things and can be understood from multiple points of view—economic, scientific, ethical, legal, and even spiritual. But in the end, health care is about people. It is a network of human relationships that people have designed. Health care can never be more effective, more efficient, or fairer than the image in its designers' minds. That image, of course, is the designers' meaning of health.
In many ways, health care reform is like a chronic disease. On one hand, the health care system will always be adjusting to perturbations, for we can assume that in the future newer worldviews will envelope our postmodern understanding of the world. On the other hand, because health care reform and chronic diseases both unravel familiar relationships and self-images, we can learn to rebind and strengthen relationships, evoking new levels of intimacy; or we can let the relationships fray or fracture.
The parallel between personal illness and health care reform is clear and instructive: We are vulnerable to the actions of others. Although the media is replete with stories of families and even whole communities [joining hands and hearts to help an ailing member,] much more often the sick are