In the article “Health Care and Equality of Opportunity”, author Gopel Sreenivasan posits that the argument that ones’ right to health suggests that they should have access to healthcare, is flawed; equal opportunity does not require universal access to healthcare. In one supporting argument he uses to defend his thesis, Sreenivasan argues that even if access to health care is held constant, socioeconomic status seems to strongly contribute to the distribution of health (Sreenivasan, 24). This suggests that universal healthcare may not be the solution to the problem of health, but rather, other social determinants may greatly influence health and we need to look deeper into these other issues and try to come up with other solutions to the problem of health. In the Whitehall study, mortality rates and cardiovascular prevalence were investigated in British men ranging from ages 20 to 64. All of the subjects were stably employed, lived in the same region of greater London, and had free access to health care provided by the NHS. The subjects were divided into 4 cohorts as defined by the British Civil Service: administrative, professional/executive, clerical, and “other” (Sreenivasan, 24). The interesting findings in this study showed that after nine years, clerical civil servants had significantly lower mortality rates than the “others”, and the mortality rate for professionals is more than a third lower than that for clericals. Following the trend, the mortality rate for administrators was in turn a third lower than that for professionals (Sreenivasan, 24). The results strongly support the idea that socioeconomic status makes a contribution to the distribution of health.
Energy should be devoted to improving the social determinants of health and not so much emphasis should be placed on universal healthcare. Yes, access to healthcare is very important, however, there are other factors including race, gender, and social status that prove to be problems of fair opportunity (Beauchamp, 264). The ethical principle of justice is the underlying issue in Sreenivisans’ article. Justice in this case is referring to the equitable allocation of health. Unfortunately, not everyone is treated the same. For example, minorities, women, and the poor, all have significantly compromised health in comparison to their counterparts. Social factors thus prove to have negative effects on health, and if justice were being served on the race, ethnicity, and social status levels, disparities in healthcare would cease to exist.
I believe it is important to understand why these health disparities even exist. Unequal access to quality health care is one very important one. But there are other important factors, including education, and living and work environments. Race and income are also often correlated to important health risk factors, like smoking, being less active, and obesity. To me, equal opportunity looks like placing Whole Foods supermarkets in neighborhoods where there are food deserts, limiting the amount of alcohol stores in poorer neighborhoods, and having access to great public schools. I believe these will definitely help to diminish health disparities and they serve a greater purpose than simply providing equal access to healthcare.
Works Cited
Sreenivasan, Gopal. “Health Care and Equality of Opportunity.” Hastings Center Report 37.2 (2007): 21-31. Web.
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.
I agree with you that a superior approach to this issue is to focus on the social determinants of health rather than an individual’s access to healthcare. We already know that the United State’s healthcare system does not work efficiently.
Refer to second graph on this link: http://www.minney.org/more-your-money-private-healthcare-vs-publicly-funded. Instead of focusing on improving low-income neighborhood quality, I believe that we need to focus on the quality of food that low-income individuals are eating. Since impoverished citizens can only afford fast food, they consume a very unhealthy diet. As for the middle- and upper-class citizens, they can afford healthier food options. By creating equal food sources for all citizens, healthy food options seems like both a more plausible and more reasonable approach for success and evening out the disparity.
From reading your post, I think that Sreenivasan provides an interesting argument about the fact that universal healthcare may not be the best approach for equal opportunity. However, my main question for you then is how do we even the playing field for those individuals who were born with poor health? As we discussed in class with Rawl’s idea of creating a just society where you may not know which socioeconomic group you would end up in, how do we make it fair so that unequal health issues we are born with are accounted for? I do think there needs to be a way to balance for health issues in those individuals who have poor health and are in a lower class socioeconomic group, if we want to have a just society.
Danielle,
I think you bring up some interesting points and make an engaging argument. I agree that there are many factors that contribute to a person’s health. Simply providing universal access will not eliminate health disparity. There are various social determinants in addition to healthcare, which affect a person’s health, quality of life, and mortality. The issue of health care is very complex and multi-faceted, as there is no obvious right answer and many social determinants serve as puzzle pieces. Environmental factors are often pivotal in determining a person’s health status. I agree that educating individuals about how to maximize their health while also providing healthier food and recreational options can have an impact on improving health, but that is only a start. I disagree with Sreenivasan, however, because “equal opportunity” implies that everyone should have the opportunity to access adequate health resources, suggesting that equal opportunity necessitates universal access. If care cannot be accessed, opportunity does not exist. While access alone does not guarantee the elimination of health disparity, providing a means in which individuals can access proper health care when needed can improve health at an individual level.
Hi Danielle Moskow,
Yes, the reality of life is that not everyone has an equal opportunity to life just because of the socioeconomic class they were born into. You ask “how do we make it fair so that unequal health issues we are born with are accounted for?” I believe that there just needs to be a system put into place where no group is marginalized and those individuals who were born with poor health are given the extra care that they need regardless of what socioeconomic class they are born into. Thus I agree with you when you state that “there needs to be a way to balance for health issues in those individuals who have poor health and are in a lower class socioeconomic group, if we want to have a just society.” A lot of work needs to be done where everyone is getting a level playing field. In response to Jonah, I agree that providing access to healthy “food options seems like both a more plausible and more reasonable approach for success and evening out the disparity.” I believe that diet has a lot to do with much of America’s most prevalent chronic diseases such as heart disease, cancers, and Type II diabetes.