In this case (Case 2.2) in “Well and Good” the issue concerning social determinants is reviewed. IT specifically looks at a woman named Martha, who has suspicion over a growth in her mouth she suspects is oral cancer. However, Martha and her partner are both unemployed and care for three children. So, when her doctors recommend a series of tests and regimens for her to follow she consciously declined treatment since she was not able to pay. This case brings about issues concerning public policy and healthcare.
One of the questions that arose for me: was the length at which universal healthcare should stretch to? In the case, it mentions how in Canada only 50% of low-income citizens. Many people believe that dental care is a luxury form of healthcare. Even in the US, many plans do not cover many dental procedures, as they are not deemed necessary. Under the Affordable Care Act, there is an extreme lack of dental coverage and to get any kind of dental one must get outside care/coverage. However, at what point to we deem medical care as necessary or superfluous. In the case of Martha, her symptoms were seen as a sign of a possible severe illness or it could have been simply a direct result of prior poor oral hygiene. But, with poor coverage for issues such as dental/oral concerns many people are subject to live in conditions that severely lower their quality of life. At what point do we quantify beneficence and try to establish a way to maximize profit from healthcare. Although most people will agree that things like heart conditions and kidney failure are more important to treat for people, is it fair to subject people to live with tooth decay or serious oral issues.
The interesting thing, that ties into the idea of social determinants, is that poor people are the ones that fail to get coverage. It’s not like the coverage for these issues are not an option, they are just not a viable option. I know that universal healthcare programs cannot cover everything for everyone, but where do we draw the line for what is a ‘health privilege’ . How can we protect the underprivileged from being stripped from basic health needs? Since we are able to determine some health measure to be “extra,” what stops other basic needs to be put into that category. I feel that with determinants like this opens a slippery slope to removing more coverage from the poor while only supporting people that have the means to pay for the luxury of healthcare.