For the most part I think the logic in Gopal Sreenivasan’s “Health Care and Equality of Opportunity” is well reasoned. While he argues well what he sets out to, my issue with his paper is not how he reasons through his argument, but what his argument is. As highlighted in the title, Sreenivasan article discusses how health care interacts with the equality of opportunity. I believe that we should not be talking about equality in terms of opportunity or health care, but rather equity. In our current world equality is not something that exists on a large scale and it is unreasonable to believe that we can solve this problem or even come close to a solution. So when talking about health care I think we should try to base our discussions in reality and center our discourse on how to move towards equity rather than equality.

Sreenivasan spends a large portion of the article outlining why it is better to put money towards decreasing socioeconomic inequality rather than putting that same amount of money towards universal health. While considering the data and options he presents this appears to be a correct conclusion, it is based off the incorrect assumption that these are the only options. It would be possible to use the money for other programs such as a progressive health care plan. In a progressive health care system, the lower someone’s income the more support they get from the government and vice versa. While this system is not at all equal, it is equitable. A progressive health care program would access many of the benefits of universal health care and decreasing socioeconomic inequalities without have to pick one or the other.

To be optimal, this system would also have to take into account some of the social determinants of health (i.e. “those social factors outside the traditional health care system that have an effect-either positive or negative-on the health status of individuals in a given population” (23-24)). It is not clear what the balance should be between progressively funding health care and working on public health initiatives to decrease/increase the negative/positive social determinants of health especially focusing on those which affects people in lower income brackets more than others. More in depth research would be needed to be done to figure out the optimal balance between funding these two options and the ideal amount would vary on a case to case basis. Due to this variation, it would be impossible to get the absolute best solution, but I believe that a system can realistically be developed that is better than Sreenivasan’s framework allows for if we strive for equity instead of equality.