Health is not Healthcare

In regards to healthcare inequalities, Daniels writes, in his article “Justice, Health, and Healthcare”, that a society’s health is strongly affected by its social inequalities, such as unequal distribution of income; therefore, we, as a society, must bridge the gap between these social inequalities thereby eliminating health inequalities. He uses empirical evidence to support this argument, quoting studies that show the more unequal a society is in economic terms, the more unequal health is in that particular society. One strong suggestion he makes is that income inequality leads to educational inequality which leads to health inequality. Not only do these inequalities lead to poorer health but he states that it also “erodes social cohesion” within the society. Utilizing Rawl’s Theory of Justice, a supporter of Kantian Contractariansim, Daniels argues that since it is morally just to protect opportunity and distribution of goods, these social inequalities are unjust. Furthermore, since health inequalities are a result of these social inequalities and further limit opportunity, they too are unjust. Therefore, Universal Healthcare is necessary to promote equality.

Sreenivasan, criticizes Daniels argument in his article, “Opportunity is not the Key”, stating that Daniels has missed an important factor by assuming that health and healthcare are essentially the same thing. He argues that health is indeed special in terms of equality but “access to healthcare” is not the same moral right and therefore, is not unjust. Using Daniels own empirical evidence, he states that since health inequalities are a result of socioeconomic inequalities and the fact the universal healthcare has been shown not to work in terms of equalizing health, such as in the UK, then a just society has a duty not to provide universal healthcare access. Instead, it should utilize all its resources to equalize socioeconomic inequalities.

Although I have in the past been a strong proponent for Universal Healthcare, our discussions in class on the sheer complexity of what would be necessary to provide minimum healthcare to all and what exactly the definition of “ decent healthcare” would entail, I find myself agreeing with Seerivasan that the socioeconomic inequalities are the true culprit in an unequal society and that we must work on closing the gap between these inequalities first and foremost. Thinking of these inequalities, I found myself stuck on Daniels suggestion that income inequality leads to education inequalities which leads to health inequality. Is this the correct cause and effect order or do they blend together? I do see how income can lead to education inequalities through unequal distribution of state resources. However, I believe income inequalities ultimately stem from generations of individuals being lost in a poor education system. As a result, they do not have the same resources as others and cannot find a job with equal income. Both inequalities are so strongly tied together that how does a just society chose which inequality needs to be fixed first? Furthermore, I think it would take generations to fix these inequalities in any society. For example, fixing the education system now will not show economic results until those children enter the workforce. So, in the meantime, what do we, as a society, do while we wait for the inequalities to diminish. Can we stand by and let the current generation suffer so that in the long run future generations have greater opportunity?

Revised Schedule March 25 - May 5

Here is the revised schedule for March 25th through May 5th. I’ve written in the bloggers assigned to particular days, but Lebenswelt, mighty skunk, Wasabi, and my_silent_orchestra will each have to pick a new set of readings to blog about.

Mar 25 (Wallace)
Brock, “Cloning Human Beings: An Assessment of the Ethical Issues,” 6th Ed., 631-643

Apr 1 (Wallace)
Steinbock, “Respect for Human Embryos,” 6th Ed., pp. 668-671
Ryan, “Creating Embryos for Research,” 6th Ed., pp. 672-683
Theory: Religious Ethics, pp. 20-23

Apr 8 (Lebenswelt)
Marquis, “Why Abortion is Immoral,” pp. 547-555
Thompson, “A Defense of Abortion,” pp. 567-576

Apr 15 (ILoveLucy)
Arras, “Physician-Assisted Suicide: A Tragic View,” pp. 484-487
Dworkin et al, “The Philosophers Brief,” pp. 488-495
Theory: Nonmoral Considerations, Modes of Moral Reasoning, pp. 35-41

Apr 22 Review Day

Apr 29 Final Exam

May 5 Papers Due (Tuesday, 5pm)

Why equalitarian proposal is morally wrong in Health Care System?

It is ideal to have a health care to every body's benefit; however, there are limitation resources knowledge and also disagreement what is right or wrong in peopl's mind because of limitation and disagreement. so we need accept the policy that has both moral diversity and inequality.

We have to recognize that people who want to have better quality of basic health care benefit through private resources by their own freedom of choice that is a way to purchase their health benefit; however, if people who can't afford to purchase their own private insurance, then, there should have a state system for funds, for those people, for their basic health care benefit. People should agree and accept that our health care system would not be equalized same as moral diversity and disagreement in our social setting.

In equalization in health care system would have limits people who like to purchase private insurance by their own ability. Our disagreement about equalization in health care system is similar to those people who disagree about abortion right, artificial insemination, assist suicidal euthanasia that not resolvable in general moral secular terms and lot of disagreement in public norms for fairness.

Is There a Right to a Decent Minimum of Health Care?

Author Allen E. Buchanan for this essay is professor of philosophy in public policy at Duke University since 2002 and written 6 books in biomedical ethic, social justice, international justice including international law. he served staff philosopher for president's commission on Medical Ethic 1983, and 1996 to 2000. I am giving you author's back ground information that it help us understand better his article.

Definitely, Buchanan is favor of having Universal health care that "our government to guarantee a decent minimum health care for every body(p:525)." not only certain people but for every body to all person with backing up coercive power and policy by state or federal to succeed for this application.

we have already has had special rights for health care for man and women who served country that sacrificed for the good society and social welfare for the country, and people can argue for other group that injustice argues for American African and Native American. There are many clinics already for indigent groups through all of the United States with enforced principles requiring toward familiar public good by rotating physician to participate for runing clinic smoothly beside their own practice.
If our societyin health care change to all one category of Universal health care then poeple who want go freedom of choice to pick their own health care for better treatment, there will be very unhappiness among the lot of people who diminishing their freedom by that. Also where all these cost of Universal health care will be coming from even if it would be working in the future?

Health Care Irrespective of Socioeconomic Status?

In the commentary "Class, Health and Justice"many different possible solutions to the inequalities in health care distribution are listed. It is a known fact that in most societies, there is a definite difference in the health care distribution which is the direct result of a difference in socioeconomic status. Simply put, money rules everything. It governs not only the opportunities available to us (with regards to things such as education) but also the treatments that we are able to receive (for example, health care).

Four possible solutions to resolving this inequality were listed:
1. Maximizing the total sum of health of a society
2. Equalizing levels of health between classes
3. Maximizing the health of the lowest socioeconomic class
4. Give priority to eliminating and treating the sickest individuals

Before reading this commentary, I will admit that I was 100% for universal health care. I didn't see any issues with equalizing the health care provided to all socioeconomic statuses until the point was brought up of how underlying egalitarianism would have to extend far beyond just issues of health. This would only result in a socialist society, which in theory seems morally just, but we know it just does not work.

After completing the commentary, my position had changed to my believing that the fourth solution would be the best. I however must mention that I could not ignore the consideration listed towards the end of the commentary: "any attempt to locate the source of injustice in class inequalities in health is the notion that people bear some responsibility for their own morbidity and mortality."I strongly agree with the statement that each individual is somewhat responsible for their health. I know there are definite exceptions, especially when considering genetic predispositions, but why should health care be equalized when we don't know for sure that everyone has the same goals and life plans? Many individuals may not care about their health and may engage in activities that deteriorate their health, so I do not believe that they should receive equal treatment as someone who chooses not to engage in such behaviors.

Even in agreeing with this statement, I think that the fourth option is still the best as it gives advantages to those who really need it. Not only this, but in attempting to help those that are the "worst-off", we are also eventually helping ourselves by directing our resources towards diseases that desperately need cures.

The Haves Get Sick Too

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?

Equal Opportunity in Health Care Can = Individuals' Successes or Failures

Daniels argues that equal opportunity in health care is relative to how one views "justice" in health care and the question of justice in health care poses other questions like - should health care be viewed as a commodity like owning a TV or automobile, or should it be categorized separately and viewed as "special"?

For me, the author's most interesting argument was the one most developed, the normal opportunity range as a consideration for health care differences. Daniels asks us to take into account people's life plans and how their health might contribute to their success or lack. This is ultimately (according to Daniels) is how health care should be judged, if it is fair or equal really depends on whether or not it allows individuals the opportunity to reach their life plans without being hampered by illness.