By Mike Magee, MD

On July 4th, I was reading The New York Times, and at the end of the first section found a full page reproduction of the Declaration of Independence. I read it with pride in our founders, their idealism and courage, knowing of course that the union was established with acceptance of injustice and inequities -- necessary compromises that it was felt at the time were needed to hold the colonies together. And I wondered to myself, how well have we done? What injustices and inequities remain? Where is our union going?

In the famous preamble, the capsulation of the founders' principles and ideals, they leave no room for debate, no suggestion of compromise:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty and the pursuit of Happiness."

Life - the act of living, and living fully to our God-given potential.

Liberty - "the condition of being free from restriction or control;the right and power to act, believe, or express oneself in a manner of one's own choosing; the condition of being physically and legally free from confinement, servitude, or forced labor."

The Pursuit of Happiness - referring, it has been said, "to one's economic vocation of choice rather than the more ephemeral search for emotional fulfillment, although one may be predicated on the other."

And as I read, I thought, in the United States today - 232 years later-  the lack of access to a reliable, efficient, forward-looking, effective health care system makes it impossible to advantage these "unalienable rights" for a large segment of our population.

Without health, you can not reach your full human potential. Without health your liberty is restricted by disease and disability; confining, enslaving, and burdening the mind, body and spirit in such a way as to create a daily struggle, an unrequested and unwelcome labor that restricts productivity at every turn. Without health you can neither pursue effectively your economic vocation (which for many assures absent access to employer-based coverage), let alone emotional fulfillment and true happiness.

And, yet I read, it is the purpose of government  "to secure these rights, ... instituted among Men, deriving their just powers from the consent of the governed."  And yet, clearly our government hasn't provided such leadership, hasn't stepped to the plate. Is it that they have lacked our "consent"?  Or - as with slavery, voting rights, working conditions - that change require determination and hard work to secure equality? Perhaps, when it comes to assurring health for all in our country, we just haven't worked hard enough to make it happen.

The document before me states  "all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed." Perhaps we are so used to inequity and injustice in health, and all the suffering that it brings to the people and the people caring for the people that we simply can't muster the strength to "right" ourselves. Or is it possible that our leaders do not yet see, or at least have not yet accepted that health is necessary  "to effect their Safety and Happiness"?

Whatever it is, the document accepts no excuses when it says "it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security." Who are our old guards in health care? Must they be thrown off for us to free ourselves, or can they be reformed, transformed?

The document makes clear that patience has run out. "In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people." Over the past two decades, have we not petitioned; has not everyone from the IOM to RWJ documented our injuries; have not many of us felt those who denied our care were tyrants?

And as I read, there were these final words, which made me sad; that we have not been able to properly care for each other, to create a government that lives up to our history, our beginnings. They said  "And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor."

Pledge to each other our lives, our fortune, our honor. God bless America, our leaders, and our citizens. We must do better.