Is health care in the U.S. a right or a privilege?

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Health Care Organization HCA-302-CL02 March 4, 2012 Instructor: Name

The health care system in our country is broken. I don't think anyone can dispute that. There are 46 million uninsured people in the United States; it was one of the richest countries on earth, including almost 9 million children. Often, those who are uninsured must choose between financial ruin or getting the health care they and their children need. That's unconscionable. There are arguments for and against everything and studies supporting and opposing everything. I'm trying to look at the health care issue with common sense. The obvious answer to me, and many Democrats, is universal health care. We need some system, or combination of systems that will permit those who are uninsured to get the coverage they need. Any healthcare received from our government is a privilege, not a right. Helping a needy person late at night on our porch may be a civil duty for the just, but by no stretch of the imagination is it a legal obligation. Likewise, any healthcare received from the government should not be an assumed mandate to anyone living in the United States, but assistance provided to those who are in need by a helpful government. According to the Institute of Medicine, The United States is virtually the only wealthy, industrialized nation that does not provide universal health care to its citizens. Universal health care is provided in most developed countries, in many developing countries, and is the trend worldwide. After hearing this, many immediately flock to the bandwagon of bickerers and complainers on

the matter. Why would a nation as powerful and intelligent as the United States not offer medical assistance to anyone living within its borders? How can every country on the American Continent south of the Rio Grande offer some form of universal healthcare while the US remains heartlessly aloof?

One of the most difficult issues facing the United States health care system is combating diseases. Even with mortality rates continuing to decrease and with life expectancy rates continuing to increase, these trends are masking concerns with specific diseases, injuries, and population groups. The diseases that still give us a formidable challenge include many varieties of cancer, some kinds of infectious diseases, and influenza. The second difficult issue is health disparities. These disparities are widespread. Differences in how patients receive treatment and the access to treatment are measurable through financial, physical, and attitudinal indicators. Disparities affect all groups of our population. These disparities are related to race, sex, language, genetics, age, and income. We all could benefit from a more efficient system, which removes or minimalizes disparities. The third difficult issue facing the health care system in the United States is paying for health care. In the United States, we have had insurance as the biggest payer of health care for many years. There has been evolution in the types of insurance and how they manage aspects of the business. Insurance companies have been held captive for the most part by the parties holding the checkbook, the employers who

pay for the insurance for their employees. Employers need to enlighten themselves and begin to have an interest in accomplishing national health policy outcomes and protecting their employees (Williams & Torrens, 2010). Technology is one key to improving our nations health. Technology has had an economic impact on health care. It has been described as either the major driver in the rise of costs or one of many driversbut not the sole driver. In the short term new technologies have shown to increase cost while long term use of these technologies have been shown to reduce total costs over time. Technology has had an impact on in the clinical arena as well. It has had a positive impact in the clinical practice. New technologies have improved what physicians are able to do for their patients along with the outcomes for their patients. Technology has had an impact on individual patients. We now have the Internet and other new technologies that have helped us to be more informed about our health care and illnesses. One of these new technologies is the direct to consumer advertising. This is probably one of the most controversial technologies. Many Western European countries and several other countries around the world follow a similar model of health care as in the United States in terms of technology and the medical community. Some of these countries, like the United Kingdom, use a national health care system known as the British National Health Services, while others use a system of national or regional financing, like the Canadian system. Each province runs a separate

governmentally sponsored health care program. Some countries have a combination of government system and private systems for those who can pay. There is currently a shift in world populations with regards to growth, trade, and control of resources. The shift is underway to move toward the Asian and developing markets and away from European and United States markets. Biomedical research is shifting its focus to these markets as well. These newer markets hold power to be producers of health care products and to be users of these products and services. These newer markets are deciding whether to have government owned, operated, and funded health care systems or to simply provide funding for private companies. There is no universal fix to the complexities of each country and what they face with regards to their health care needs. Health care is a fundamental need among all peoples. Each country will have to work on solving the disparities that exist in access of care, funding of care, and availability of care. Because we now find ourselves facing the dilemma of fighting many infectious diseases once thought to be under control, we must work with all countries around the world. Every country faces the potential of an outbreak of a disease like SARS or a terrorism strike involving biological or chemical agents. Global initiatives to improve the health of nations across the board regardless of resources in these nations will benefit all. We need to continue with consistent and comprehensive measures to ensure health equity to all.

We face many ethical issues which include: issues in developing resources, in economic support, in organization of services, in management of health services, in delivery of care, and in assuring quality of care. In developing resources, health personnel, facilities, drugs, equipment, and knowledge are all critical to public health. The types and amount of these are will be crucial to meeting the ethical requirements for public health. Personal autonomy and respect for privacy remain critical, but the welfare of society merits close regard for justice. It is important that everyone have equitable access to health care with dignity. In many cases this warrants universal health care. In organization of services, the most important thing is that the services be organized and distributed according to the needs and ability to benefit. The management of health services involves: planning, administration, regulation, and legislation. These management services need to provide efficient, appropriate health care to all who seek it. Administrators have been faced with the profit squeeze and been dealing with many things like downsizing and providing care with less qualified staff instead of using nurses. Although it seems to be neutral at first glance, health services management has to rely on principles of humanitarianism, autonomy, and justice in making decisions. In delivery of care, the ethical issues involve resource allocation, which means rationing of health care. The ethical issue of rationing by ability to pay is immediately apparent when this idea is discussed. Sometimes rationing health care may be more beneficial. If we look at Canada who pays approximately one-third less per person than the United States and

they seem to have indicators surpassing the U.S. in health, it shows us that rationing care could be better. In assuring quality of care, the ethical issue involves providing fair and equitable distribution of medical care. This means that waste and inefficiency be eliminated. We need to gain and distribute knowledge about what is useful and medically effective. There have been strategies developed for assuring quality of care in recent years, which include: peer reviews, practice guidelines, report cards, and malpractice suits.

References

Faria MA Jr. Health care as a right. Medical Warrior: Fighting Corporate Socialized Medicine. Macon, Georgia, Hacienda Publishing, Inc., 1997, pp.94-103.

Williams, S. J., & Torrens, P. R. (2010). Introduction to Health Services. Mason: Cengage Learning.