There is no denying that there are vast differences in the longevity, healthfulness and availability of adequate health care between those in high income brackets as opposed to those in low ones. Political pundits offered their opinions on this subject for months during the recent race for our nation's newest President. This disparity is no longer considered the big pink elephant in the room, but rather one that has bore it's way to the forefront of our attention as our nation's jobless rate climbs, insurance rates sky-rocket and diseases like heart disease and cancer loom over our aged thoughts. In the article Class, Health And Justice, authors Marchand, Wikler and Landesman weigh in on this topic and offer four main points of justice/equality and health.
Point 1 - Equity as Maximization (moral assumption: everyone is treated the same as a matter of justice regardless of how this might effect other social programs)
Point 2 - Equity as Equality (moral assumption: everyone deserves to live a long, healthy life, therefore "improvements for those who are better-off financially are not as valuable as improvements in health for those who are worse-off")
Point 3 - Equity as Maximin (moral assumption: the poorest amongst us should have the best health possible without regard to "equality")
Point 4 - Equality as Priority to the Sickest (moral assumption: socioeconomic differences are not taken into account at all - whomever is suffering the most should be treated with the best available resources)
The authors also skimmed the idea of the causation of and individual responsibility for illness and how diversity of culture can play a role in both, but left that discussion in a rather neutral position.
I agree with the fourth point because who doesn't value being healthy particularly when we are sick? I appreciate how the authors redirected the attention not on the obvious disparities that class causes in health care, but on the actual needs of the sickest and how their needs could best be met. Ultimately even if one favors the idea of creating equality by providing a leveled field for the "Have-Nots", given the evidence, often it is the Have-Nots who suffer from the worst health and live the shortest lives so their needs would be best met with point 4 as would anyone who was seriously suffering from illness. Equality in health care to me is the opportunity to help those who need it the most, regardless of race, creed, religion or economic status or lack and I think point 4 brings that idea home. What do you say?
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After reviewing all 4 points on health and equality, I would say I feel the 4th point is the best way to go, but still questions remain. I agree with the point that whomever suffers the most should be treated with the best available resources, but what if they are treated, and then decide not to take care of themselves, be it diabetes, etc. It becomes a pattern, over and over again, and then what next? Not to sound like people don't deserve a chance, but do those people just keep getting treated over and over even if they refuse to help themselves when they are fully able to?
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