A month ago, I had the opportunity to visit one of the CDC’s exhibitions entitled, “Health is a Human Right: Race and Place in America” The exhibition examined challenges which made it difficult for certain minority groups and socially disadvantaged peoples to receive equal access to healthcare throughout history. The exhibit attempted to show that, whether due to socioeconomic and/or political factors, many groups of people in the United States are being forced to live without the basic resources that ensure health, including clean water, sanitation, housing, food, and health care. The purpose of this exhibit was to explain that health should be accessible to everyone, and that universal health should be provided to people regardless of their status, class, race, or gender. The exhibition emphasized that the aim of universal health should be to ensure that all people have equal and rights and access to health services without suffering from financial difficulty. However, this raises the ethical dilemma of whether or not providing universal healthcare alone, guarantees health and well-being. Do we have any social or moral responsibilities and obligations in other’s overall health? According to Gopal Sreenivasan, in his article, Health Care and Equality of Opportunity “one widely accepted way of justifying universal access to health care is to argue that access to health care is necessary to ensure health, which is necessary to provide equality of opportunity, but the evidence on the social determinants of health undermines this argument.” Sreenivasan further argues that “universal access to healthcare” and “actual health and well-being” are two different phenomena. His suggestion is that “instead of introducing a national health insurance scheme, [if] we had spent the same amount of money on equalizing the distribution of social status – then our society’s gradient in health would have been significantly reduced.”
What Sreenivasan points out is that well-being in terms of an individual’s health status, first requires a commitment of social investment for public goods because the socio-economic class is a deterrent in providing fair share of health to people. Sreenivasan explains that a “social determinant of health is a socially controllable factor outside the traditional health care system that is an independent partial cause of an individual’s health status.” For example, poverty alone is the cause of many unpleasant health problems; for the poor even small costs to visit a medical clinic can be devastating for the family’s financial situation; merely providing an equal amount of care to them would not be enough. Sreenivasan’s argument implies that we should invest less on health and more on limiting the negative consequences of social determinants of health; the objective should be to tackle socioeconomic factors that create major discrepancies in health inequalities.
As was witnessed in the CDC exhibit, there are many political complexities preventing us from promoting and offering universal healthcare, we should still strive to achieve this goal. However, this should not be the only goal we strive for. As Sreenivasan states, offering healthcare alone will not create drastic improvements in the health of the general population. While we must offer healthcare, we must simultaneously battle the socioeconomic forces that worsen the health of the economically marginalized. If we can strive towards accomplishing these two goals, we can reverse the course of the history of healthcare and overall health of the general population.
Sreenivasan, Gopal. “Health Care and Equality of Opportunity”. The Hastings Center Report (2007). Pg 21-31.