Access to Healthcare:

Healthcare is one of the world’s largest institutions. Everyone wants to be happy and lead healthy lives. But what does it cost to be happy and healthy? Trips to the local physician cost money, and can be expensive. If one cannot afford to make a trip to the doctor, he or she may remain ill, injured, or uncomfortable enough to reduce happiness. Humans are born with the right to health and happiness and should have equal opportunities to access healthcare in order to maintain this health and happiness. But what if they can’t? What if some are of victim to the social lottery and do not have sufficient funds to cover the costs of private healthcare to be healthy and happy? Public policies are developed to make sure that those who may not be able to provide the necessary funds to cover private healthcare can still receive public healthcare covered by insurance. This system works because while it helps those who suffer from the social lottery, it also helps those who suffer from the natural lottery – those with serious diseases and conditions that the average person will not experience on a normal basis. The system assumes that the average person will be spending significantly less money than the few that require the most funds. But to what extent should these patients with extremities be covered? We explore this question with the following 3 cases.

Cases:

Case A – A 48-year-old electrical engineer is laid off, and is no longer covered by health insurance. Upon developing an inguinal hernia, he is unable to receive surgery and cannot afford the procedure himself with the current mortgage payments. The county hospital disqualifies him from the surgery, as he is a homeowner with two vehicles. Is his situation justified to receive the surgery free of payment? It is hard to say. The county ruling of disqualification of the surgery may be a very questionable ruling. The cars he owns may be only worth one or two thousand each whereas if he owned one car for $100,000 then he might qualify for the fact that it is only one car versus two that are owned. According to Utilitarian Theory, welfare decisions must be made based on the maximization of utility for society. This view may be in favor of the engineer as he has much utility to benefit society as a healthy person rather than maybe a fry-cook at McDonald’s. An inguinal hernia is a potentially life-threatening condition. A utilitarian would argue whether or not he would be able to get another position as an engineer before retirement in order to justify the treatment.

Case B – A 5-year-old boy consistently falls victim to fevers and ear infections and has already ruptured his eardrum at one point. The closest charity hospital is 50 miles away and takes his mother several hours to get him there via bus, after already receiving a ride into the town. In this case, the child and mother are cursed by the social lottery as they do not have necessary funds to attend a private physician nearby and do not own a vehicle to increase accessibility to the charity hospital. In this scenario, is it justified to receive a car under health insurance to accommodate the situation? Some patients undergo treatments for years and cost insurance companies and hospitals thousands of dollars. Can these payments be translated towards a vehicle? While there is no way to measure the monetary benefits of the time saved from commuting to the hospital via car versus a ride into town and then a bus, it is a debate with many factors that should be considered. A communitarian might argue in favor of providing transportation to the mother as the car would not be a cost to those in the community, but it would potentially aid the 5-year-old with help to prevent drastic consequences to the frequent ear infections and fevers.

Case C – An old couple encounters a dilemma that threatens their marriage. The husband has been diagnosed with Alzheimer’s disease and must be put into a nursing home as the condition worsens. As Medicaid will not cover the payments, the wife must mortgage her house in order to come up with the funds. A lawyer suggests that all assets be moved into the wife’s name and then a divorce occur in order to make the husband eligible for Medicaid as an indigent. A libertarian would be appalled at the situation. All humans have the right to liberties, and that should include marriage. If society has driven this couple to assume the route of divorce in order to qualify for payments to be put into a nursing home due to such a saddening and hopeless disease as Alzheimer’s, then something must be backwards. If this will allow the husband to qualify for Medicaid, then it should be justified that the payments should be given to him anyways and spare the couple from divorce. Both individuals are scholars – the woman a librarian and the man a college professor – who benefit society and others, and the wife should be spared from undergoing the processes of red tape while her beloved is withered away.

Conclusion:

While these 3 cases show different angles at which people can be faced with obstacles to receiving health care, there is a common question that begs to be answered: under what circumstances should one be denied healthcare, or should everyone receive the healthcare? When one stretches as far in our society to say that a personal car should be justified as a form of healthcare, it is easy to say that we may fall into a slippery slope into providing funds for anything if it can be justly argued to link to healthcare. The problem is that not all the funds in the world are available to help every single person, so who is the judge to say that one circumstance is more deserving than another?

WORKS CITED

Beauchamp, Tom L., and James F. Childress. “Justice.” Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. 249-67. Print

Brody and T. Engelhard, “Access to Health Care,” Bioethics: Readings and Cases