Beauchamp and Childress propose a two-tiered system of health care. The first tier covers basic and catastrophic health needs. The second tier, includes better services such as luxury hospital rooms and cosmetic surgeries at your own personal expense. They claim that this system “guarantees basic health care for all on a premise of equal access while allowing unequal additional purchases by individual initiative, thereby mixing private and public forms of distribution” (273). This system is too general. There are several ways to treat a medical issue and at times many diagnostic tests are needed to find out what the exact medical issue is and how to treat it. So what would be included under basic services? Also does not address the historical injustices and prejudices of the medical system. Minority populations have been targeted for unethical medical research and blocked from necessary medical care. A just health care system has to take into account these injustices and prevent them from happening again. The system must also attempt to right the wrong that occurred and repair the damages that were done. For example, the blood of Henrietta Lacks was studied in the lab. Her cancerous cells helped create lifesaving vaccines, but she was never given proper treatment for her illness. Some of her cells are still used today in research. Until recently, there was no compensation for the use of her cells. Immediate members of her family did not even have access to health care due to a lack of insurance, yet Lacks cells brought millions of dollars into the health care industry. Recently, the government gave her family full free health coverage to attempt to right the wrong that was committed. Using Lack’s cells without her permission violated her privacy and autonomy. The health care system has to account for the historical medical injustices that occurred. There are systems and ideologies that reinforce institutional racism, especially in the health care system. A fair system has to actively attempt to deconstruct these systems and ideologies. Therefore, the health care system cannot be general. We have to address very specific aspects of what is right and wrong. We also have to stop acting like we live in a perfect world and recognize the wrongs that have been done in our society and address them. A decent minimum must account for the barriers that people have to overcome in order to have health care. We also have to recognize that access to health care does not automatically translate to the use of the health care system. People, especially vulnerable and minority populations, are very skeptical of the medical system because of the historical injustices. Therefore, I believe that the health care system should give more benefits and help to vulnerable and minority populations because they are extremely disadvantaged. The only way to close the disparity gap and begin to build fairness is to disproportionately target vulnerable and minority populations for social and health benefits. This is very similar to the egalitarian view of justice.
References:
Principles of Biomedical Ethics: “The right to a Decent Minimum of Health Care”272-279.
I agree with your point that the hospitals must provide better services to everyone especially to the vulnerable populations. In order to correct what is wrong, there is need to look back and consider the injustice that has been committed throughout the history. The vulnerable population groups have been ignored for a long time as evidenced by the case of Henrietta Lacks. I like the idea of giving more benefits to the vulnerable population. It is different from health care being accessible to them like how you differentiated the difference between the two. As a side note, I believe we can also define the word accessible differently by including the ability of people to receive the care – not only matter of how far one should go to receive it but also the process and the cost that can’t be ignored. Anyway, if we support this view, I think there might be a counterargument, asking whether we should just give them the fish or actually teach them how to fish. To specify a little bit more, they might argue maybe we can provide means for them to earn it with the reason being that it would be unfair to people who “earned the cupcake,” if you will. However, in this counterargument, there is a crucial, key component missing: health care is a right that should be guaranteed to everyone. Therefore, I believe that it simply doesn’t make sense to have it earned. I hope that people would agree it is just for anyone and everyone to receive the health care as long as they are part of this society at least.
I agree with your statement that the current healthcare system does not give enough attention to vulnerable populations. I believe that plans should be put into place to give greater amount of care and resources to these areas. For example, one model I really like is the one of our local hospital Grady. Grady provides members of its county access to healthcare and provides many programs and resources to allow people to become educated. Specifically, in the realm of sexual health, Grady offers its patients access to various types of contraceptives so that they can be better equipped when dealing with their personal decisions. I agree with your idea of the egalitarian view of justice and believe its a great start to handle the historical prejudices in the healthcare system.