Tag Archives: government

The social lottery of life

Coming from a middle-class family, where my parents had stable jobs, medical insurance was never a topic of concern. I always went to the doctor for my yearly check-up, whenever I was feeling sick or to the hospital for accidents and emergencies. It was  not until the 2011 presidential debates that I became aware of the lack of equal access to healthcare in the United States. It never crossed my mind that some people would avoid doctors and hospitals due to the lack of insurance.

According to  Brody’s article “Access to Health Care,” I have a high social lottery, but not everyone is fortunate as myself. In the U.S., we do not have socialized medicine, but we believe that everyone has a natural right to health care and thus should have equal access to it. This is why we have free clinics and hospitals which are required to treat all patients without question in emergency situations. Additionally, over the past century, the government has established Medicaid and Medicare, programs for the disabled and the elderly, respectively. Medicaid provides free health insurance to individuals and their dependants who are deemed indigent for which each state has its own criteria. On the other hand, Medicare is provided to everyone over the age of 65 and the benefits are uniform across the country. Both are funded by the federal government, but the government will only allot a certain allowance for every diagnosis and any additional expenses must be absorbed by the patient and ultimately the hospital.

Our current medical care system is flawed and it results in tension between providing the best health care, providing equal care for all, maximizing provider and consumer choice, and cost containment (Brody). One of the biggest problems is cost containment, for it is a vicious cycle. There are approximately 8-11 percent of Americans do not have any form of health insurance. These Americans often have diseases that go undiagnosed or untreated until it becomes a serious medical emergency and are transported to the hospital where they are treated immediately. The cost of this type of treatment is exponentially higher than if that same person had affordable or free access to healthcare and was treated earlier. Furthermore, these patients usually can not cover the costs, and so the hospital absorbs the costs. To account for these losses, hospitals increase the cost of treatment, insurance companies raise premiums, and the government hikes taxes. Ultimately, the taxpayers and the insured end up paying for the uninsured.

There is no simple solution to this problem that pose no downsides, but the government’s goal is to find a compromise of how to provide the best healthcare for all while maximizing provider and consumer choice. There are two popular models of socialized medicine, that of Western Germany and that of Britain.  In the Western German system, individuals under a certain level of income are covered and they may choose to purchase additional coverage in order to have the benefit of a semi-private room versus a ward. This results in over 99 percent of the population being covered while maintaining freedom of selection of physician, whose salaries are not severely diminished in the process. In the British system, the National Health Service covers everyone and they are provided a local physician, who refers patients to specialists where they will be wait-listed for an appointment. This system is completely free, yet if a person so chooses they are able to see physicians on a fee-for-service basis. The British system is better at maintaining lower health-care costs than West Germany and the US, but the disparities in the timeliness of care and the physicians salaries is much worse in Britain than West Germany and the U.S. Personally, I believe that the U.S. should try to model its healthcare system after West Germany. A simple first step, while we continue to debate this, is to place everyone under the Medicare system regardless of age.



Brody, Baruch A., and H. Tristram Engelhardt. Bioethics: Readings & Cases. Englewoods Cliffs, NJ:Prentice-Hall, 1987. Print.