Category Archives: Healthcare justice (week 7)

Allen E. Buchanan: Attractions and Specialized Right to the Decent Minimum Policy

In “The Right to a Decent Minimum of Health Care”, Allen E. Buchanan argues the faulty premises of universal right being justifiable for a mandatory decent minimum policy in health care. First, he explains logically and coherently the attraction towards, not the reasoning for, a mandated decent minimum policy for healthcare by our rational thought. Next, he explicitly explains through the combined weight of arguments from special rights to healthcare, harm-prevention, prudential arguments, and enforced beneficence is sufficient enough for a decent minimum of healthcare. In his special rights to healthcare, Buchanan emphasizes that there be no individual right to health care but a societal duty relying on the actions of all. 

Buchanan explains his three main reasons why a decent minimum policy seems to be a great idea at first glance. First, allocating resources from health care to other social policies would be a byproduct of health care having a decent, adequate minimum; as many prioritize health differently. It also stays on track with the societal obligation to help those in need and those of the less fortunate. Lastly, Buchanan exclaims that it is a floor beneath an individual, a safety net of some sort, to allow a person to put some priority on their health care. I agree with the second and third points of Buchanan’s interpretations of attractions towards the decent minimum policy; societal obligation and a safety net. However, his first point runs on the same assumption made by Alan Goldman, in which health and longevity are not priorities to a large majority of society. I would believe that most of our social policy expenditures are on health care and education to better ourselves as humans, so most of society would still spend money on a “higher level” of health care despite the decent minimum. This idea intertwines with the idea of individual autonomy, as the freedom to choose ideal personal health care is enhanced when nutrition is in its best form. Therefore, allocating resources would be a difficult task as this creates equal opportunity in such a case for those who do not prioritize health at such a high value. From an economic, realistic point of view, this may be exceeding the resources health care can provide and making the decent minimum policy less attractive.

In his suggestion to alter the decent minimum of health care, Buchanan argues the idea for special, not universal, rights to fit the definition of the decent minimum more effectively. Buchanan is attempting to enhance the decent minimum policy by disintegrating the vagueness of a universal right. He, once again, uses three primary groups of people that should receive a decent minimum policy. One group for those involved in a rectifying past or present of injustice, such as Native Americans. Another group for those who have suffered unjust harm or been unjustly exposed to harm by others. And a final group for those who have had exceptional sacrifices for the good of society, such as the military. I believe Buchanan does a great job transitioning to these arguments after explaining the counter of why a decent minimum seems but not is, a great idea. I agree with a more specialized right rather than a universal right, but, in my opinion, it seems to be specialized to the point of little to no effect depending on the requirements of the groupings. Also, it could be argued as discriminatory. With more details to his specialization, Buchanan effectively eliminates the universal rule to the decent minimum policy. Overall Buchanan is relying heavily on societal duty, through the sums of individual action, and aspiration of a decent minimum of health care. He fails to ensure and solidify his different approach to dividing health care for society, but does offer an interesting opinion.

Daniels on Healthcare

There has always been and will always be arguments surrounding the need for the more socialist style of healthcare. Healthcare where the discrepancies between wealth and education do not matter- the only priority is making someone better, no matter the cost. Norman Daniels argues for this equal opportunity rights. The backbone of his argument dictating that; disease and disabilities restrict a person’s range of opportunities, and healthcare’s job is to maintain the “normal” functioning of people so that they too can have access to all of life’s opportunities. He argues that prior education status or wealth should in no way affect this right to healthcare as it is the basis of our functioning society.

Arguments arise surrounding this topic. Questions such as; too what extent should “free treatments,” be given out to people? From Daniels argument, it can be said that any issues considered to affect someone’s range of opportunities should be treated fairly with healthcare; however, assessing what affects this is difficult. How much treatment is too much? How much is too little? It is entirely subjective. Being from the UK this is an area of significant interest for me. In the UK, we have the NHS, considered as the first real socialist form of healthcare. From an outsider’s perspective, it seems excellent and fair for all, but under the shell, it is the cause for numerous issues. If you spoke to a Briton, most would say that the NHS is dying and is an awful system, altogether. There is a lack of care in all aspects. The NHS is spending large quantities of its budget on the treatment of just a few diseases, those relating to; smoking; obesity and type 2 diabetes. These three alone consuming around 85% of the NHS budget. Now, as a patient in the system, these lack of funds show in the quality of the hospitals (most are relatively small and look not far off a prison. Nothing compared to Emory.) As well as, in the wait times (at minimum 2 hours) and even in the parking (costing not far off $10 an hour). The whole experience of healthcare is awful. Not only as patients but also as doctors because this lack of money finds its way to them, most getting paid just over minimum wage to work long and tiring shifts. Everyone in the NHS system is overworked on the whole. So, from afar healthcare for everyone seems fair and just, however, once put into reality, some may argue it worsens care as a whole. In theory, it works, in practicality maybe not so much.

Now Daniels does make some arguments surrounding what he deems to be a limit on “necessary treatment.” Using his principle that healthcare’s job is to improve a person’s functionality and allow them to have fair opportunities to everyone else- Daniels claims that anything outside of this does not warrant healthcare. An example of this being plastic surgery or cosmetic surgery. These surgeries are there to enhance your appearance only and that by doing them it does not improve your equal opportunity rights. They do not enhance or improve functionality or ability. It is in areas such as this that Daniels draws his line. Healthcare, according to him, has one purpose, keep people functioning at the best they can so that they too can have equal opportunities.

Daniels does present a well-argued view on healthcare and the need for it. He presents a good argument as to what is considered “necessary treatment,” and what should be covered under healthcare. However, looking at a first-hand example of healthcare, it is easy to see where cracks begin to open in his argument and the practicalities of a healthcare system. Questions indeed arise in the UK and my family in terms of the weighing of costs vs quality of care. Is free healthcare worth it despite the quality of care being poor? Is it worth just paying for private healthcare which gives faster results and better overall care? These are questions I am thankful enough to ask due to my position and ability to answer them; however, for some, these questions can never be answered as they cannot afford private healthcare. Healthcare as a topic is complicated, and there is no single solution. However, using Daniels theories, it is easier to quantify what treatments fall under the healthcare bracket of care.