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Ethics & Health Care Reform. Is there a right to health care? What's right? If there is a right to x , then there is an entitlement to x. If there is a right to x , then society has an obligation to protect or enhance x .
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Ethics & Health Care Reform • Is there a right to health care? • What's right? • If there is a right to x, then there is an entitlement to x. • If there is a right to x, then society has an obligation to protect or enhance x. • In the case of health care, if there is a right to health care, then how much health care is there a right to, and how much of that can we afford to support?
Ethics & Health Care Reform • Rights: Positive and negative sides • e.g. Right to free speech: • Positive: I can speak freely in appropriate situations • Negative: I cannot be prevented from speaking freely in appropriate situations • e.g. Health Care: • I have a right to health care at a certain level provided by the state, i.e., a public health care system • I am not prevented from participating in, nor others from offering, a health care system, i.e. private health care
Ethics & Health Care Reform • Where do rights come from? • God, e.g., Declaration of Independence: Life, Liberty, Happiness • Nature • Social Contract • Government creation
Ethics & Health Care Reform • Rights: • de jure: by law • de facto: by practice • e.g., education • We have the right • We must exercise that right • Government pay and requires education • Why a de facto right? • Economic consequences • Required by a functioning democracy
Ethics & Health Care Reform • Rights are often checked by other rights. • e.g., abortion • Freedom of speech • Rights can have limits. • e.g., Because of cost • Right to health care: Why? • Are education and health care parallel to one another? • Health care enhances equality of opportunity • Health care allows citizens to fully participate in democratic institutions
Ethics & Health Care Reform • Current health care concerns • 42+ million Americans uninsured, many underinsured • Corporations reducing their support for health care • Lack of insurance for pre-existing conditions • Rising costs • Rising paperwork • Maldistribution of physicians and health care institutions
Ethics & Health Care Reform • Current health care concerns • Socialized medicine • e.g., the V.A. • National Health Insurance, government is sole payer, e.g., Canada • Insurance reform or regulation • e.g., Require to cover pre-existing conditions • Government is insurer of last resort • Managed care, HMOs, PPOs, etc. • Main goal: cost control
To a Young Physician • For those patients, tablets of frailty • Storied bodies stretched out before you • Needs upon needs • Look on them with your heart • Let their story - not their history - merge with yours • Touch them with your hands and your words • Let their skin rub on your in concern • Embrace them in their loneliness and anxiety • Let that connect with your own • Hold them in your heart and in your mind • Let their beat rhythm your own • Teach then the causes of their frailty • And let them teach you the causes of your own • Love them as part of a bond • The vulnerable and the wounded • Mercy's kind intent and love's rich content • Be with them for they are your being
