One of the largest health problems facing the nation today is access to medical care. With around 50 million people uninsured, our country struggles with providing health care to many individuals. Because the scope of this problem penetrates all facets of life, it needs to be tackled at many different levels. Deciding our values as a society about health care requires answering difficult ethical questions. The means by which we begin to create and implement a national health care system necessitate that we define what those values are. Addressing the challenges of providing national health care is inherently part of the discussion around this dilemma.
One initial question that must be asked is: How responsible is an individual for the status of their health? Factors that contribute to one’s health include their environment, genetics, socioeconomic status, behavior, and the actual health care obtained. Because of the variability of these factors for each person and the unpredictable nature of individual health, responsibility should ultimately be shared among families, communities and society. It is known that approximately 10% of the population accrues 70% of total health care costs. The financial burden this poses on individuals with acute, chronic, or terminal illness is substantial. Do we want to live in a society where access to health care is determined by socioeconomic status? Aside from social responsibility, we have personal interest in creating a system where the burdens of this financial risk are spread across the population; our health circumstances are just as uncertain as everyone else’s.
The costs of health care are significantly rising at an unsustainable rate. Maintaining a healthier population not only benefits the individuals but also the payers (insurance companies, employers, government) of the expenses. How do we incorporate individual responsibility into the equation? What financial contribution should individuals make? Should it be experience based; should individuals pay premiums based on their health care history? Or should the payments be based on a community rating, where everyone pays the same regardless of their health status? Or should it solely be based on ability to pay, a tax financed system? How do we promote healthier lifestyles while recognizing the injustices that exist? It is less likely that someone living in poverty would have access to a fitness center. This person may also live in an unsafe area, making it difficult to take walks after work. This person may not be able to afford healthier foods, relying on foods with less nutritional quality to feed him or herself. The more we recognize the barriers that exist, the more responsibility we feel to help create a system that provides for everyone.
Even once we recognize that universal health care is essential, there are more questions to be answered. How would we go about implementing universal health care? What role should government play? The current structure allows for minimal governmental regulation and relies highly on free-market economics to regulate the system. Increasing governmental regulation would inevitably decrease our choice (as it has been observed in countries where it has been implemented such as Canada). We must decide that we value access for all over choice for those privileged enough to have this conversation.
Increasing access of information to individuals, determining what values as a society we have, implementing a system that insures health care to all individuals, and deciding how to finance this system are significant challenges regarding this issue. However, recognizing that access to health care is an ethical issue is a critical step in the process.
For more information: http://www.everybodyinnobodyout.org/FAQ/fqIndResp.htm