Public Health is an emerging field that has goals to improve the the access of healthcare to all individuals. Some believe that equal health care is not attainable for all. Some believe that there should be a bare minimum for all people and they are entitled to this right. However, is it really possible to create a bare minimum of health care for all? There are those that realize this concept, and strive to work against the negative effects of social determinants in our societies. Sreenivasan states that, “Social determinants of health, roughly speaking, are those social factor outside the traditional health care system that have an effect either positive or negative, on the health status of individuals in a given population”. There is obviously a relationship between access and quality of health care to the wealth of an individual. However, it is important to note that health care is not the sole control social factor that significantly impacts one’s health. The article makes very realistic points about how we should view the social gradient. If we were to achieve this idea of “equal opportunity”, every one would “more or less” have the same access and quality health care.This article does not stress that there is a right to health care for all. However, there are organizations that strive for this goal, and have had great successes in reaching this goal. For example, PIH and BRAC have both made great strides toward better health care regardless of the amount of wealth a person accumulates. Sreenivasan more or less states that there is always going to be someone that doesn’t have health care, and doesn’t believe that everyone has a right to health care. However, Buchanan’s article is a very good contrast to the points made in Sreenivasans article.
Buchanan’s article seems to hold a perspective that may be better applied to the outlook of how health should be viewed. Buchanan states, “The main difficulty is that assuring any significant level of health for all is simply not within the domain of social control.” The article discusses how the idea of equal opportunity, but is it truly realistic. Also, it is noted that there is a strong difference between a decent minimum of healthcare and access to health care. Which one should be implemented? There may or may not be a better choice depending on finances and other factors, but which one seems to be more realistic in our world today? Can we provide a decent minimum for all? An important point to note is that people require different levels of health care. People have different cases and diseases that all require differing levels of money to treat. There will always be someone that doesn’t quite receive the adequate amount of healthcare that they should receive, and the reality of it is harsh. However, as a society we can try our best to treat the ones that are affected negatively by these social determinants. There may be wiggle room for the bar to be set as to where to begin treating everyone, but how do we establish a set bar? Each case can have a different level of severity and urgency, so can we really make a bare minimum in the field of public health.
References
Sreenivasan, Gopal. “Health Care and Equality of Opportunity”. The Hastings Center Report (2007). p. 21-31.
A. Buchanan, “The Right to a Decent Minimum of Health Care”. Philosophy and Public Affairs (1984). p.55-78
I think that it is possible to establish a “bare minimum” level of health care that is guaranteed for all. As long as it is clearly defined, and efforts are put forward by all parties involved, I think that it is an achievable goal. Just as the MDG have been defined and agreed upon as plausible goals for the year 2015, a “bare minimum” within the US, should certainly be possible. It is extremely inefficient, and in its inefficiency time, resources, and money is wasted. This is where the difference can be made. In other words, if we “clean up” the healthcare system, and mold it into something that is much more efficient and unified, a goal such as “bare minimum” healthcare could be achieved. There is a difference between “absolute health” and “relative health”. If we bring up the bottom line of absolute health, the population in general will be in a better situation. As for “relative health”, it is unlikely that there will ever be equal opportunity for equal health care for all. There is a huge amount of money that is lost in our healthcare system.
I think that equal access to healthcare is more easily achievable than equal minimum of healthcare for all. Some peoples’ minimums will be higher than others’, which creates a rift in the “equality” aspect. We can more easily create equal access, which is essentially what the ACA is trying to accomplish. Everyone will have access to healthcare when they need, and they will be covered, too. ACA gives grants and discounts to people who fall in the coverage gap, aka the donut hole. By address the donut hole in American healthcare, the ACA is actually working toward more equal access rather than an equal minimum. The rebates and the government responsible are key to making healthcare easily accessible to those in need.
I agree that there is a huge number of social factors that impact one’s health. I would even argue that health care affects it to a much lesser extent then things such as nutrition, living conditions, etc. I agree that in order to create equal opportunity, we not only need to change access to health care but also decrease poverty. I see Sreenivasan’s point that a minimum level of health care is impossible to attain especially when one takes in to account the other factors. I think access to health care is a lot more important and fare than creating a minimum standard.
Personally I believe that it is possible to have a bare minimum health care for each country, but it is impossible to establish a global bare minimum health care. This is because there are many social factors affecting the health care system such as economy and that each country has different levels of development or economy. So what if these social factors change in time, should government change the minimum health care? I believe so, because in that case, the government can produce the most effective health care for everyone. As you point out that each person requires different levels of health care and that in this case, some people might not be able to receive the right amount of healthcare. But should we be looking at the benefits of the society or the individuals?
I definitely was interested with your articulation of there existing a bare minimum for healthcare. One idea that really stuck a chord with me regarded the supply of doctors. If we were to provide equal access to healthcare to everyone, there would be a significant increase needed in the doctor work force. In order to fulfill this need, new medical schools would either need to be established, or the current standards of medical schools would have to be lowered in order to accept more students. If either of these were to happens, there would be a dramatic increase in the number of doctors, yes, however there would also be a significant increase in sub-par doctors. So then when discussing the bare minimum of healthcare, we then must also look at the bare minimum of the quality of healthcare, not just the access. Just something I thought was attention grabbing.
I think it is both possible and important to establish a “bare minimum” in regards to health care. I do agree, however, with Sreenivasan that social determinants of health are incredibly important to address and possibly even a more effective means of achieving a healthier population than putting more funds in to health care. It’s important to address the upstream causes of poor health and not just treat it when it appears. Social determinants of health determine whether or not the poor health outcome will exist in the first place. I’m curious though if we can apply the same concept of a “bare minimum” to social determinants of health as well? Is it realistic to think that we can provide everyone with a habitable, clean home? Or a supply of healthy food? A gym membership, perhaps?