Introduction
Debates regarding healthcare costs and coverage in the United States have been persistent for several decades, as identifying a system that is morally sustainable whilst being economically sufficient is extremely difficult. While there are several programs in place to ensure that individuals are medically covered, healthcare costs in the United States have been increasing at a rapid rate from year to year. Currently, America’s healthcare system is mixed, meaning it is made up of both public and private elements. About 65% of citizens under the age of 65 are privately insured, or getting funded from non-governmental sources. While 25% are publicly insured, meaning they rely on government funding. This includes programs such as Medicare as well as Medicaid. The other 10% of citizens are left uninsured (Figure 1). Even though this seems like a small number, this is still equivalent to about 30 million citizens.
Figure 1: Insurance in America
Ethics: A Deeper Look
With this system arises various ethical implications that are detrimental to individuals all over the nation. This is especially true for those in poverty as they are often unable to afford adequate healthcare services without further harming their financial state. This also leads to large amounts of discrepancies in healthcare distribution, as those with financial stability have a large amount of power in regards to the healthcare that they receive, as well as those whom they may be funding, highlighting the overarching moral issue. When looking at these issues in a holistic view, it becomes apparent that, regarding healthcare in the United States, capital is favored over individual health.
An Economic Perspective
According to George M Martin, a professor at the University of Washington Seattle, medical costs are rising at alarming rates, to a point where research shows that from 2001 to 2007, the percentage of healthcare-related bankruptcies has risen nearly 50%. Not only are an increasing number of people facing bankruptcies from medical costs, but about ¾ of these people are insured, well-educated, and amongst the middle class. The inefficiency of the current healthcare system is highlighted by this, as if even those who are supposed to be “well-off” and economically self-sufficient are having trouble paying healthcare costs, it must be extremely detrimental to those that can’t even afford to financially sustain themselves with the necessities of life.
Figure 2, National Healthcare Expenditure- % of GDP
As the years go by, the American government is spending an increasing amount of capital, as reflected by the GDP percentage, on healthcare (Figure 2). Additionally, Tracey LaPierre, a professor in medical sociology, claims that America spends the most on healthcare compared to several other prominent nations. While this may look like a good thing on the surface, it is actually detrimental to the economy because more costs are being put into healthcare while citizens still are not reaping the benefits, as previously mentioned. Dan Polsky, an expert in health economics, puts this all together, claiming that America’s system, with its high administrative costs and complexity, is unable to uphold the demands of the people regarding healthcare, therefore proving to be somewhat ineffective in regards to satisfying those relying on the system.
The Social Situation
Currently, the situation in America regarding the health of individuals is extremely insufficient not to mention unethical, as it severely impairs not only the economic state but the health of those in poverty. As stated by the World Health Organization, poverty creates hazardous conditions for the individuals in that situation, not to mention it puts them at an extreme risk of undernutrition. With over 800 million individuals currently living in the slums and being habitually exposed to several health hazards, by 2020, this number will likely increase to 1.4 billion as an effect of the truancy of effective policy involvement.
As a result of the widespread disregard of basic needs regarding health, a strong case can be made regarding the allocation of resources that give priority to those in need. Overall, the unmet need for those facing harsh economic situations that restrict them from gaining fundamental resources highlights the need for more government assistance regarding healthcare. This assistance would provide the prolific amount of individuals that are currently suffering from these unfortunate circumstances with better conditions that would drastically alter their lives for the better.
Potential for the Future
With the abundant amount of individuals currently in poverty and struggling to financially support themselves, it is ethically unacceptable to continue pursuing the healthcare system presently embodied in the United States. This system is especially detrimental to those in poverty regarding health and financial means. A solution to alleviating ethical healthcare struggles is by providing the citizens of America with universal healthcare, which is a system in which the majority of individuals have their healthcare covered, typically through taxation. With this system, the same standard of care would be provided to all patients by physicians, and those in serious need of healthcare would have proper access. Overall, it becomes apparent that there are many more benefits of this system, and it, therefore, is a plausible solution when considering the extent to which the government should cover healthcare costs in the United States.
Reem Hassoun, Youth Medical Journal 2021
References
Chau, Kao-Ping. “Overview of the U.S. Healthcare System.” American Medical Student
Association, February 10, 2006, https://publichealth.arizona.edu/sites/publichealth.arizona.edu/files/Chua_Kao-Ping_HealthCareSystemOverview_2006.pdf
Cicconi, Lora and Strug, Kerri. “Universal Healthcare in the US.” Ethics of Development in
Global Environment, May 25, 2000, https://web.stanford.edu/class/e297c/poverty_prejudice/soc_sec/universal.htm
“FastStats – Health Insurance Coverage.” Centers for Disease Control and Prevention. Centers for
Disease Control and Prevention, January 20, 2017. https://www.cdc.gov/nchs/fastats/health-insurance.htm.
Hanson, Kara, Lucy Gilson, Catherine Goodman, Anne Mills, Richard Smith, Richard Feachem,
Neelam Sekhri Feachem, Tracey Perez Koehlmoos, and Heather Kinlaw. 2008. “Is Private Health Care the Answer to the Health Problems of the World’s Poor?” PLOS Medicine. Public Library of Science. November 25. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050233.
Himmelstein, DU, Thome, D, Warren, E, et al., “Medical Bankruptcy in the United States, 2007:
Results of a National Study,” The American Journal of Medicine, 122(8): 741-746 (2009).
Martin, George M. “Views on the Ethical Struggle for Universal, High Quality, Affordable
Health Care and Its Relevance for Gerontology.” Experimental Gerontology, U.S. National Library of Medicine, Jan. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237434/.
Nicholson, Thomas, et al. “Double Standards in Global Health: Medicine, Human Rights Law
and Multidrug-Resistant TB Treatment Policy.” Health and Human Rights, Harvard University Press, 18 June 2016, https://www.ncbi.nlm.nih.gov/pubmed/27781001.
Rossiter, Louis. “RISING COSTS FOR HEALTHCARE: Implications for Public Policy.” PDF
File. February 2009. https://www.wm.edu/as//publicpolicy/documents/nfibrisinghealth.pdf
Schrecker, Ted. “Denaturalizing Scarcity: a Strategy of Enquiry for Public- Health Ethics.”
Bulletin of the World Health Organization, World Health Organization, Aug. 2008, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649456/#__ffn_sectitle.
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