Health care is a human right. Forty-four million people are uninsured in the United States. Therefore, the United States does not believe in health care as a human right.”

Or, All corporations think primarily about profits. Hospitals are corporations. Therefore, all hospitals think primarily about profits.

Or, The patient needs should come before concern for money. Doctors and insurance companies think primarily about money. Therefore, doctors and insurance companies do not really care about patient needs.

Or, Prescription drugs that I need are too expensive. Drug company CEOs take home millions of dollars in salary and bonuses. Therefore, drug company CEOs prevent me from getting the drugs I need to live.

I hear these arguments, and countless others, quite frequently. If I were to try to capture the essence of the logic, it might be something like this: Those of you who work in health care have lost your way; shame on you. Isn’t health care a right for every U.S. citizen? Shouldn’t patient care always come before profits?

Of course, the answers we have to these comments and questions are swift and sure if we are a victim of the system. Yes, of course health care should be a right! And yes, patients must always come before profits! Why can’t others see this like I do, we ask ourselves? Why doesn’t someone step in and do something about it? What are they afraid of?

The sheer number of problems, voiced sharp and indignant, about our healthcare system is overwhelming. It is like looking up into the night sky and trying to comprehend the infinite number and varieties of stars; it is paralyzing in complexity. But our paralysis is due to the questions we have chosen to ask. They are the wrong ones.

What if, instead, we were to shift our focus from finding culprits and knights in shining armor to looking at ourselves? What if, before we looked to intervenors to fix our problems, we had to answer less philosophical and more practical, more personal questions, such as:

What are the “haves” (most of us) willing to give up that is precious and might even be painful, so that the “have nots” get access to health care if they want it? In other words, would we forgo a new car, that planned vacation to Disney World, buying expensive new clothes, getting the new iPod or dazzling cell phone, reducing going out to a restaurant to only once every three months, sending our children to a less costly state college rather than private liberal arts college? What would hurt, and would you volunteer to experience it for another’s benefit?

If our poor lifestyle choices (eating junk food often, drinking in excess, smoking tobacco, driving too fast without seat belts or helmets, not exercising) had some negative effect on our health, how much of a penalty should we pay so that others who made healthy lifestyle choices feel rewarded?

And finally, the most difficult question of all:

At what point would you decide to withhold (ration) some level of medical care that had little probability of success (the cost/benefit was clearly on the cost side) so that the money saved would benefit society as a whole?

If we do not answer these questions explicitly, we will be encouraging two others to step in to do something about the health care mess we all contributed to, and they are unafraid. The first is the competitive marketplace. The second is government. Neither works well on its own, so there is an attempt to combine the best of both. One will focus on efficiencies, performance and innovation, the other on fairness, justice and equity. It is meant to be all things to all people, and an answer to the questions posed. But, of course, if history is any guide, this marriage of convenience will not be as effective as we hope.

The fundamental questions really aren’t about health care rights or CEO salaries or the motivations of doctors or hospital administrators or insurance company execs. Rightly or wrongly, these symptomatic issues simply detract us from the more basic questions that we find tough to answer. The questions we now ask may provide us with self-righteous indignation, but they do nothing to help change the situation. The emphasis is to fix the blame on others for our predicaments and keep the camera focused away from us.

By answering these more fundamental questions, we are on the road to taking personal responsibility for our behaviors that contribute to the health care jumble, as well as our contribution back to society to help the “have nots.” Only then can we more fully focus our attention back on the performance of doctors, hospitals and the insurance and pharmaceutical companies.

The answer to the three questions posed in this article will prepare us for the dramatic changes that will be required for health care in the United States to be seen as fair, just and equitable.

Michael D. Skinner of Surry is a retired hospital administrator and current full-time faculty member and director of health care studies at Husson University, teaching undergraduate and graduate students.