Spiritual practice includes how each of us interacts with and supports the Web of Life, and that Web includes our brother and sister humans. This is especially true in regard to the fundamental issue of health and well-being. Everyone in the tribe is important and valuable, and the basic quality of life of each person in the tribe reflects on the spiritual relationship we have with all things.

If we do not treat others of our human tribe with honor and respect, how can we believe that we do so with non-human tribes? How can we call ourselves a “spiritual” society?

As far back in prehistory as we have been able to penetrate, one of the key characteristics of what we determine to be human is how they care for each other. There is evidence that even prehistoric non-human species such as the Neanderthal took care of their sick and dying. Because of this, we believe that they were self-aware and aware of the importance of the individual to the tribe, and we credit them with “human” qualities of compassion and family value.

In our current healthcare debate, such human sensibility is not so clear and certainly is not a given. I believe there is nothing essentially wrong with a strong healthcare system supported by a corporate structure. However, unlike a social system accountable to the people, a profit-oriented corporate system can readily fall victim to unrestrained greed. We have seen this in the financial sector, and I believe this is what we have seen develop since HMOs first appeared in the early 1970’s.

Since then, healthcare has evolved from a public service to an industry. We no longer call it the politically-sensitive “healthcare industry” as we did then, but “healthcare system,” yet it is the same thing.

Corporations are not directly accountable to the people; they are accountable to their shareholders. To the extent that the shareholders are dedicated to providing healthcare to everyone who needs it, that is fine. To the extent that they are dedicated to ever-increasing profits (which is true of every other “industry” in the capital system) that trade on people’s health and well-being, they serve to disrupt and unravel the very foundation of the society, which is our tribe.

So it now appears that we in the U.S. will continue to have a corporate healthcare system. We seem to have gone too far down that road to turn back. Now, to do otherwise would require a fundamental overhaul of the entire healthcare delivery system, and there is no apparent social will to do so. That would be “too difficult, too expensive, too disruptive, too frightening.”

Accountability, then, must be directed to those participating as leaders in that system. Currently, there is precious little of this, and when the glare of social accountability does come, it generally comes too late: someone has died needlessly.

So I offer some guidelines to help us sort out the issue of accountability.

~ In a healthcare system dominated by insurance companies, the denial of basic coverage to any person due to their inability to pay is a condemnation of the board and shareholders of that company. They are to be held accountable.

~ The death of any individual due to the denial of life-saving procedures or medicines by an insurance company or hospital is a condemnation of the board and shareholders of that company or institution. They are to be held accountable.

~ The dumping on the streets by a hospital of any individual due to inability to pay for their care is a condemnation of that hospital’s board and shareholders. They are to be held accountable.

~ Any employee of an insurance company or healthcare institution who puts their responsibility to the board and shareholders above their responsibility to the health and well-being of their patients and clients is a condemnation of the board and shareholders of that company. They are to be held accountable.

~ The suffering or death of any volunteer rescue worker of 9-11 or any other disaster, due to inability to pay for their care, is a condemnation of the elected officials and citizens of that state, as well as the board and shareholders of the institution refusing such care. They are to be held accountable.

And fundamentally:

A nation is measured by the way it treats the least of it citizens. A country that has the greatest number of millionaires and billionaires in the world, and yet allows its citizens to suffer and die because of their ability to pay for healthcare, deserves to be shunned by the rest of the world.

As one of the world’s greatest spiritual leaders has said: “As you do to the least of these my brothers and sisters, you do also unto me.”