Guessing what goes through readers’ minds as they read headlines can be hard, but I’m going to try: “Another bloody column about health care reform? What, am I, bonkers? Hasn’t this been written to death by now? Please, write about anything else, even snow removal or sidewalks.”

How did I do?

Well, despite the obvious attraction of snow removal policies as a topic, health care reform is the target today, mainly because “today” is when it’s on the front burner politically. And I’m not the only one who keeps writing about health care reform. Last week featured yet another guest column with a local opinion on reform. I wrote one back in September, and others before that. Letters have been exchanged, as far back as the year we moved to Freeborn County. When I look back over my own writing, health care reform was featured as far back as 1992.

It’s because the topic won’t go away until we actually answer some big questions we’ve been ignoring.

Health care reform has been on the agenda for years — mainly on the agenda of progressive politicians, it’s true — but it’s been discussed and written to death for nearly a hundred years.

Although the political party championing reform has not always been the same (ironically enough, it started with a Republican), at least one of the opponents has been: The AMA, defenders of the status quo — at least once they had gotten rid of the midwives and other health-care providers that used to be the status quo in American medical care.

Among the questions that haven’t been answered in all those years are ones about insurance and profit. Why are we so obsessed with the insurance side of basic medical care? The real problem lies in the costs of the care we Americans don’t want to give up. We don’t want to lose our high-priced treatments on demand or the employer-subsidized deluxe insurance packages that pay for them. We really only want costs controlled for those whose medical care is paid for by the government.

And why are we still protecting the ability of investors in huge corporations to make profits off the diseases and accidents of others? Using profits to build better facilities or invest in better treatments seems perfectly reasonable. Using those profits to buy vacation homes in Aspen or a new Jaguar every year do not.

At the top of my list of questions that won’t go away, however, is the one about health care as a right. Oh, the question sneaks into public discussion every so often, usually asked by voices on the left, but the discussion never really goes anywhere. And it does need to go somewhere. We need an answer to this foundational question; everything depends on how we see access to health care.

Is health care a right? Some people — including many patients — argue it is.

Is it a privilege? Others — including many providers — say it isn’t.

Do we have a right to any kind of medical care we want?

Is treatment by paramedics at an accident or emergency room care of a heart attack victim a privilege, dependent on the patient’s ability to pay?

Does the Hippocratic Oath imply a right to health care? Or is it an ethics code covering doctors’ relationships with their customers?

What’s my answer?

Prepare to be disappointed, because I don’t have one — or perhaps better to say the answer is so complicated that one column in a newspaper isn’t sufficient.

I do believe that there is a right to health care for kids and basic medical care for adults — preventative medicine and emergencies. But even as I write those words, images of motorcyclists without helmets or unbuckled motorists speeding down Interstate 90 appear. Do they have the right to the same level of care as those wearing helmets or using seat belts? What about the smoker with lung cancer or emphysema? What about the heart attack victim who celebrates recovery with a bottle of Jack Daniels, a huge steak and double order of fries?

I think it’s worthwhile noting that, technically, we haven’t answered the same question about some other things we take for granted. Is clean drinking water a right or a privilege? Is breathable air? Is the food we need to eat?

Speech is protected. Our guns are protected. Our churches, mosques and synagogues are protected. But most of the basic needs of any human are not because they’re not in the Constitution. Ironic, isn’t it? Or maybe tragic.

Answering the question about a right to health care is linked to how we think about all of those other basic needs. Like I wrote above: It’s complicated.

David Rask Behling teaches at Waldorf College and lives with his wife and children in Albert Lea.