Many people—with or without insurance—will not receive the foot care they need, and the implications are potentially disastrous. I personally have seen more patients with diabetes undergo amputations because they cannot afford the antibiotics required to fight their foot infections. 

     Stated simply, our health-care system doesn't work. Eli Siegel, the philosopher and founder of Aesthetic Realism, a New York City-based education, was right on target when he stated that profit-driven health care is unethical because it is "based on contempt for people." 
 
     In the commentary, "Ethics—The Only Answer for the Economy!" Ellen Reiss, the class chairman of Aesthetic Realism, explains: "Once you are after profit, you can't be too interested in what people deserve, what they feel: it will cramp your ability to make money from them." 

     This explains why mothers have to fight their insurance companies to approve surgeries that could save their children's lives. Podiatrists know only too well the frustration of an elderly woman who can't afford to take care of her ailing feet because her HMO, in order to maintain its bottom line, keeps podiatrists out of its panel. 

     If this is not contempt, tell me what is. Treating patients in terms of how much money can be made from them is utterly contemptible and, in my view, totally contradicts what medicine is supposed to be all about. As a doctor and a human being, I'm grateful to have learned that the only opposition to contempt is good will, the desire to strengthen people and to be fair to them. 

     Profit-driven health care is a failure, and the "patient protection" bills proposed in Congress are tantamount to ensuring that all passengers on the Titanic have life jackets. The reform proposals of both major parties do little to change the system, and neither addresses the question of caring for the uninsured. 

   "Nobody should ever have to pay for having his body cared for," Siegel wrote in the National Ethics Report of July 1968. "The idea of people worried about their health and worried about money is barbarous. It's ego corruption." 

    Health care should be based on ethics. And according to Siegel, central to ethics is the question, "What does a person deserve by being a person?" Only when we honestly answer this question can a compassionate, functional 
health-care system be devised.