Healthcare, like many “public” services, is not equally available to everyone. It is true that there is some degree healthcare available to the population at large, but, due to the private sector, the quality is vastly different between groups. There are many things that factor in to the availability of quality healthcare. Things such as income, race, ethnicity, gender, age and others all play in to the healthcare a person receives. A complete list is covered in a report on health disparities published by the CDC (http://www.cdc.gov/minorityhealth/CHDIReport.html). These factors ultimately come down to income and demographics. Preventive medicine deserves a larger amount of funding. If everyone does not have the same opportunity to protect their health, then should they be placed with the total responsibility of their own preventative medicine?
Education is a public service, but you can pay for better education; a higher level of learning to obtain a higher standard of living. Health care is also public, but again private healthcare is where the highest quality of care is generally found. Not because doctors are better, but because there are more resources and fewer patients. Preventative healthcare is no different in its access. There are many forms of public “prevention” that we may not even be aware of. Regulation of water, food, and air are a few things that prevent us from getting sick. For the US, these are the lowest level of prevention services provided. Beyond those things, availability of health prevention is not equal. In his argument Preventive Medicine, Brody states that “preventive medicine is most easily amenable to equal distribution”. At a basic level this is true, but to a greater extant preventative medicine is not equal.
One of the salient aspects in prevention is diet. It also happens to be one of the largest contributors to the prevalence of many chronic diseases in the US (WHO). Things such as food deserts and the limited influence and quantity of food stamps are directly related to income. When a family has a limited budget, and a bag of chips is cheaper then an apple, junk food trumps nutrition. Diet is an example of prevention that is not equal.
Like Brody mentions in Preventive Medicine, as a society we are more likely to fund life saving procedures then to invest in projects that will save lives before they are at risk. Nobody wants to pay you to keep them from getting sick. However, the cost of prevention is much less. Vaccines are a perfect example of how a small amount of money can save more lives if it is invested before those lives need to be saved.
With this information—of the cost benefits of acting early on health prevention and the disparity that currently exists in the US—can we raise the level of “basic” preventive medicine? Is it ethical that some people have the capacity to “protect” their own health through diet and other means, and others fall short? Why shouldn’t there be a larger public investment in preventative medicine, so that it may influence a larger population, ultimately saving money down the road?
Sources:
WHO website
CDC Health Disparities & Inequalities Report (CHDIR)—Morbidity and Mortality Weekly Report (MMWR)
http://www.cdc.gov/minorityhealth/CHDIReport.html).
BRODY, BARUCH. AND ENGLEHARDT,TRISTRAM
Book Title: Bioethics: Readings and Cases. 298-301. Prentice-Hall.1987
ISBN: 0130765228