Health Care Ethics
- Overview of the Basics
- Rural Health Care Ethics
- Right to Refuse Treatment
- Withholding and Withdrawing Treatment
- Decision-Making Capacity
- Is Health Care a Right?
- Pediatric Decision-Making
- Physician Assisted Death (PAD)
- Health Care Reform in Vermont
- Frequently Asked Questions
- Resources and Ethics Links
Is Health Care a Right?
[a/k/a: Issues of Health Care Access]
When we speak of a “right” to health care, we might be speaking of either a legal right or a moral one. It is important to be clear about what kind of right we are talking about, because while health care for all is arguably a moral right, it is not a legal right. The US Supreme Court has never interpreted our Constitution to imply such a right.
Many people – 77% in a recent poll – think health care should be a right. The US is the only developed country in the world that does not legally guarantee health care for all. But others argue that it is not the government’s responsibility to provide access to care for everyone. Some say we can’t afford it. They point out that health care spending makes up about 16% of the total US economy now and will be about 31% by 2034. Others believe we should treat health care like other consumer goods and services, and let market forces determine its availability and cost. The issue is the subject of an ongoing debate.
Right now, the main way people access health care is by paying for it, usually in the form of health insurance. But many people either don’t have adequate insurance or can’t afford to buy it. In 2008, 46.3 million people (15.4% of the US population) did not have health insurance. 62.1% of all bankruptcies in 2007 were related to medical expenses, and approximately 78% of medical bankruptcies were filed by people who had health insurance.* Even after recent reform legislation, not everyone will have access to care. Many people feel it is unjust and unfair for access to health care to be based on ability to pay.
A related issue is how to fairly distribute limited health care resources. If we had an endless amount of money to spend on health care, everyone could get everything they wanted and needed from our health care system. But we don’t. As a society we cannot possibly commit all the money and resources it would take to satisfy everyone’s health care needs and preferences. The cost would be so great that there would be nothing left for other important social priorities, like education. Because we have only limited resources to spend on health care, we need a fair system for deciding who gets what, when, and how much of the burden each of us should reasonably be expected to shoulder. How much we spend, and how we decide who gets what share of the limited care resources that are available, is a question we must answer as a society.