Paying for Health Care: Ethical Issues

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  • 0:04 Paying for Health Care
  • 2:12 Is Health Care a Right?
  • 6:00 Lesson Summary
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Instructor: David Wood

David has taught Honors Physics, AP Physics, IB Physics and general science courses. He has a Masters in Education, and a Bachelors in Physics.

Health care is important in living a long and comfortable life. However, it costs money. This lesson examines the different ways that countries pay for their health care and the ethical issues surrounding the question of whether or not health care is a right.

Paying for Health Care

Our world is mostly governed by capitalist economic systems, systems that involve trading goods and services. If John owns a water pump and Sam has a fruit tree, they can work together to provide water and fruit for both their families. The same is true of health care. Since each effort that we make has a value in the market, we sell these efforts in the form of services or goods and use that money to support our families. Health care, like anything else, needs to be paid for.

Many different systems across the world are used to pay for health care. Countries like Canada and the United Kingdom have fully nationalized health care, otherwise known as single-payer health care, where it is free at the point of use and paid for through taxes. Countries like France and Australia have mixed public-private systems, where most basic health care is paid for through taxes, but additional health care is available in the private market and is used by large numbers of people.

Other nations, such as the United States, have an almost entirely private system, with certain public systems for select groups. In the U.S the elderly can access Medicare while the poor can use Medicaid, both of which are public systems. Such countries can limit costs through a process called managed care, in which insurance companies only pay for services recommended by a doctor, and where only certain approved doctors and hospitals are allowed. The goal of managed care is to reduce healthcare costs, and includes things like providing incentives for patients and doctors to use cheaper treatments, reviews of which treatments are medically necessary, and limiting inpatient treatment and lengths of stay.

Capitalism works well in a lot of ways. However, resources are not evenly distributed. What happens if someone can't afford to pay for something? Under capitalism, they simply go without. For many goods and services, this is not a major problem. But what about things that are life and death? In such cases, people can be left without what they need to survive and be healthy. This is where people start asking the question: is health care a right?

Is Health Care a Right?

Most people believe that humans have basic rights. For example, you might argue that you have the right to free speech, and you might argue that you have the right to life itself. Many would argue that to provide these rights, we need to help each other, even if someone doesn't have the ability to pay. If human beings have a right to life, then letting someone die of dehydration would be wrong. Water is a right and the failure to provide it is wrong. This is the basic argument for how health care can be a right. A doctor with the ability to save someone's life is considered to be doing something morally wrong if he or she fails to act. It is difficult to argue that health care is not a right if you believe this.

Some have pointed out that, while many Americans claim that health care isn't a right, few would argue that people should be turned away from the emergency room. If people think emergency rooms should treat even those who cannot pay, that implies that they really believe health care is a right, even if they claim otherwise.

The counterargument to viewing health care as a right is that it is essentially a claim to other people's money. Health care requires spending time and resources to diagnose and treat people. Drugs in particular can be incredibly expensive. If health care is a right, that means you have a right to money that is currently held by other people, and you can mandate others to take action. Some argue that something which requires other people's money or action can never truly be a right. In this view, only free things, such as free speech or freedom of assembly, count as fundamental human rights. A more basic way of saying this is that a right cannot require someone to act. You can't stop someone from speaking, but you are also not required to rescue them when they are drowning.

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