When the French commemorate the French Revolution with Bastille Day on July 14, and we acknowledge the American Revolution with Independence Day on July 4, the celebrations represent different ideals. The slogans that drove the two revolutions were also different: "Liberty, Equality, Fraternity" in France and "No Taxation Without Representation" in the United States.

Through two centuries of repetition, these slogans achieved mythical status. Detailed analysis of the revolutions reveals the complex situations that created the environment igniting each country. French society evolved differently than American society, and it reflects different attitudes toward health and medical care. The French, until recently, seemed to prefer a nationalized, socialized medical system. After the recent election is that a myth?

Similarly, the debate surrounding American medical care prattles with many unworkable myths. Join me as I examine four of the myths.

Myth 1: Healthcare equates to medical care.
When individuals assess their body functions and conclude they are performing adequately, they presume they are healthy. The maintenance of our bodies in health remains our choice. Public health systems are societal measures that enable us to maintain our health.

When a person's body systems fail from any cause, he seeks the assistance of another to restore the perception of health. That person is seeking medical care.

Maintenance of an individual's health is generally a personal financial choice and responsibility. Why do many people think that that responsibility stops when the individual seeks medical care? Many believe the myth that one's personal choice to seek medical care in any form absolves him of any financial responsibility for that medical care.

Myth 2: Medical care should be equal.
Many demand that access and delivery of medical care be equal for all--that the medical care in Santa Ana equal the care in Beverly Hills. In reality, inequality exists across the world due to different needs, including rural location vs. urban location, pediatric care vs. geriatric care, and urban setting vs. suburban setting.

Achieving equal access to medical care evades all Western nations. Even in Canada, the prime minister receives different care than the average citizen. The diversity of American society requires unequal and different medical solutions for similar medical problems.

Myth 3: Medical care should not be profit-motivated.
When I hear this, I reflect on Winston Churchill's statement, "Capitalism is the unequal sharing of plenty and communism is the equal sharing of little." The profit motive created the business success of this country. Competition within medicine and healthcare abounds as all parties strive to offer profitable services and products.

From various "health clubs" (paid for personally) to artificial joints (often paid by third parties), competition on price and service provides consumers with choices. Competition stimulates innovation! Even supposedly "not-for-profit" hospitals and medical organizations thrive and grow by spending their budget excess (profit) on self-improvement.

Myth 4: America suffers from a "healthcare crisis."
That's the contention in Michael Moore's movie "SiCKO." However, in reality, Americans enjoy access to the best possible medical care. American medical care suffers from a financial crisis.

Most Americans, including me, demand the best care possible, but want someone else to pay for that care. Consequently, third-party payers created unrealistic expectations in their clients. Similarly, artificial charges for hospital care ($20,000/day) and simple office charges ($250) bare little reality to an individual's ability or willingness to pay for these services.
Market corrections, though painful for some, are the best method of achieving resolution to the financial crisis in medical care. Responding to the problem by creating a new taxation system (a single-payer national health system) defies the American Revolution ideal.

Mythological stories shed light on our human condition and our evolution as a species. However, they rarely offer solutions to problems. The French Revolution myths cannot compare with the American Revolution myths. Each revolution charted a different course. The American cry to stop oppressive taxes led to a divergent solution compared with where the French cry of equality led. When it comes to our current medical care environment, we must avoid creating solutions to mythological stories.

Lytton W. Smith, MD, editor for the OCMA, is a physician practicing family medicine with the St. Jude Heritage Medical Group in Yorba Linda. Dr. Smith welcomes feedback on his articles and can be reached at editor@socalphys.com.