Studied by 3 people
Important benefits and burdens equally shared; affirm that important benefits and burdens of society should be distributed equally
To achieve greater equality, the egalitarian (unlike the libertarian) would not be averse to mandating changes to the distribution of society’s goods or to interfering in the workings of a free market
Unlike the utilitarian, would not allow utility to be the ultimate overriding consideration in a system of distribution
To achieve greater equality, the egalitarian would not be averse to mandating changes to the distribution of society’s goods or to interfering in the workings of a free market
E.g.
Systems that give equal access to all legitimate forms of health
That offer a guaranteed minimal level of health care for everyone
Provide care only to those most in need
Best distribution is the one naturally occuring from fair free market participation; benefits and burdens of society should be distributed through the fair workings of a free market and the exercise of liberty rights of noninterference
The role of government is to protect the rights of individuals to freely pursue their own interests in the economic marketplace without violations of their liberty through coercion, manipulation, or fraud
Beyond these protections, the government has no obligation to adjust the distribution of benefits and burdens among people
Distribution is the responsibility of free and autonomous individuals
People may have equal rights or equal worth, but that does not entitle them to an equal distribution of society’s benefit
Universal healthcare would be a coercive violation of people’s right to use their resources as they see fit
Would accept a system of health care only if it is freely endorsed and financed by those who participate in it
Acquired through free choice by a group of private citizens to meet their own healthcare needs is acceptable
Will likely deny there is a right to healthcare, for they generally accept negative rights and disallow positive rights
A system for providing care to a particular group of patients (members of the system) using regulatory restraints to control costs and increase efficiency
People who enroll in a managed care plan—such as a health maintenance organization (HMO) or a preferred provider organization (PPO)—get health care at discounted prices from the plan’s network of providers (physicians, hospitals, etc.)
Managed care plans try to control costs by influencing the kind and amount of care that providers offer and by restricting the choices that members have
There is concern that for the sake of economical medicine, providers may cut corners, decide not to order necessary tests, pay less attention to patients’ needs, or refuse to treat certain serious health problems
A problem of managed care
Christine deMeurers had breast cancer
Every standard treatment available had been used, but with no apparent effect
After standard treatments failed, Dr. Mahesh Gupta promised a new treatment, a bone marrow transplant; in violation of Health Net rules on referrals (HMO), Dr. Gupta referred Christine directly to an expert at the Scripps Clinic
The Scripps doctor, however, was reluctant to help them or even provide them with information about the transplant
By the time, they had consulted with other doctors about the treatment, Health Net resolved that the company would not pay for the transplant because it was disallowed under the investigational clause in Christine’s contract
A different physician, Dr. Glapsy found himself conflicted
As her physician, he felt a responsibility to help her get the transplant
As a Health Net physician, he was also required to uphold the regulations of the HMO
After discussion between Health Net administrators and UCLA physicians, they concluded with UCLA agreeing to pay for Christine’s operation
Another panel also ruled that Health Net should’ve paid for the transplant, but instead it had improperly interfered in the doctor-patient relationship
We can best achieve just distributions of health and health care by ensuring that human rights in general are respected
Fair treatment, freedom from coercion, nondiscrimination, protection from abuse, equality, and other entitlements contribute to well-being and health
Enjoyment by everyone of the highest attainable standard of physical and mental health is in itself a recognized human right
Parceling out important limited goods
Due to the fact that people’s health care needs are virtually boundless, yet the supply of health care re- sources is ever limited
E.g. Medicare and Medicaid allot health care to the elderly and the poor
E.g. HMOs limit medical procedures, tests, and access to doctors to control costs
E.g. Hospitals restrict the use of intensive care units, emergency departments, organ transplants, etc.
Brings up questions like “who should get what share of limited health care good and services?; who should live and who must die?”
Policies for rationing try to take into account success of treatment (e.g. organ transplants) or the urgency of the patient’s needs
Insufficient resources arises both on…
The scale of the total health care system
Concerning what portion of society’s resources should go to health care and how this allotment should be used
The scale of individual patients and provides
Regarding who should receive specific resources
Strong claim: People have a positive moral right to healthcare
Libertarians:
Utilitarians:
Egalitarians:
Human Rights:
Libertarians: Reject the view; government shouldn’t be allowed to interfere
Utilitarians: Maybe, depending on the benefits minus the costs (utility) of becoming involved; endorse a derivative right to healthcare
Egalitarians: Yes, everyone deserves healthcare because it’s important; favor a bona fide entitlement to a share of society’s healthcare resources
Human Rights: Yes, everyone should be able to enjoy life on a fundamental level, and that would include mentally, emotionally, and physically
All persons have equal worth
Things like social value would not be a sound argument
E.g. A med student is not more worth saving than a poet
Trying to treat people with humanity
Mainly distributive
Advocating fair allocation of medical resources
Advocating for the fair and equal treatment of all patients regardless of SES
Respect what taxpayers want to happen with their taxes
Respecting free market and the consumer decision for insurance
Cost
Limited medical capability and medical resources
Rationing
Government obligation
Pos/neg rights
