This question confused me at first because I did not fully understand the difference between universalized, socialized, public, and private healthcare. So, let’s start by clarifying these terms, “It is important to distinguish between socialized medicine, in which the government owns the healthcare system, and universal healthcare, which is simply a system that guarantees healthcare coverage for everyone” (Introduction 441).
In other words, socialized healthcare is publicly funded and owned, while universal healthcare is not publically own but can potentially be publically funded. Universalization can be achieved publically, like with Medicare, or privately, like with an individual mandate. In the US, neither of these methods of implantation are socialized because the means of production always remain private, no matter who ends up footing the bill. So, I will not be discussing how universal healthcare should be achieved, that is publically vs. privately, although I will briefly discuss possible policy implementations in the US. Instead, I will focus on discussing what parts of healthcare should and shouldn’t be universalized.
To answer this, we must first decide if healthcare is a right or privilege. Negotiating this line between healthcare as a right or privilege is the key to making progress on this issue. Anything that is a right should be protected by the government and universalized. However, anything that is a privilege should remain untouched by the government. With this, the line between rights and privileges should be drawn based on three main parameters; individual age, technological modernity of the medicine, and medical condition unavoidability.
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To start, age parameters need to be created somewhere and the government has already come up with the ages of ~65, when Medicare kicks in, and 26, when it is no longer mandated that a son or daughter has to allowed to remain on his or her parent’s health insurance plan. Next,let’s relate these ages to rights and privileges. The opposite of responsibilities are rights because we each are responsible for each other’s rights.
For example, it is my responsibility to respect your rights to life, liberty, and the pursuit of happiness. Taking this logic, let’s look at the age of 26 or younger. It is self-evident that adults have a responsibility to take care of the young because they have not had the opportunity to develop skills and become self-sufficient. In other words, children have the least amount of responsibility for themselves and their own position in society. Therefore, at this stage in life, healthcare leans away from being a privilege, and towards being a right.
To clarify, a privilege is something that has to be earned, and if someone has not had the chance to earn it, then it is not a privilege. So, people 26 years of age and older have had a chance to earn the privilege of healthcare, and therefore, should receive less flexibility and social support in receiving that privilege. The caveat here comes in to play at the age of ~65. In this US, this demographic has been paying into social security (Medicare) for their entire lives and have earned the privilege of healthcare. This is an important because part of the reason Medicare costs so much is that maintaining the privilege of being old is expensive. In sum, old age is a privilege, and not a right, but most (but not all) elderly US citizens have earned this privilege by paying into social security for their entire lives.
Secondly, the technological modernity of a medical technology (i.e. drug or procedure) affects the degree to which access to it is a right or a privilege. This exploration of thought goes hand-in-hand with the social contract and idea that most of what we have today, especially technologically, was built on the backs of our dead ancestors. In a way, every technological innovation that we have access to is a privilege because we are all lucky enough not to have been born an early anthropogenic hunter-gather with a life expectancy that is a tragedy by today’s standards. For this reason, an arbitrary point has been set in US precedent that after twenty years, the latest innovations return to the intellectual commonwealth.
In other words, at the twenty-year mark, all medical technologies take a heavy swing away from being a privilege and towards being a right. This allows for the those who are economically privileged to purchase state-of-the-art, cutting-edge care, and in doing so, support and promote a healthy incentive for innovation. Pharmaceutical companies are able to spend the million to billions of dollars it takes to develop more drugs — the precise average cost being hard to know because conflict research estimates that the actual cost is likely “far lower than the $2.7 billion figure that the drug industry frequently points to when it justifies the soaring cost of medicine” (Harris, 2017). I am assuming pharmaceutical companies included the costs of advertisements in their analysis – this area of my research was fuzzy because of the great deal of political bias.
Secondly, a bonus to this delay in rights is that after twenty years there is likely to be enough research into the costs vs. benefits of a certain medical innovation to allow for effective decision making as to whether or not it practical to universalize a medical technology. This gives massive bureaucracies, like the US government, a chance to avoid the classic criticism of recklessly spend money. Lastly, the main exception to this rule of thumb is infectious disease. It is in everyone’s best interest to be as proactive as possible when staving off mass pandemics with the practices of herd immunity. In summary, the older a technology is, the more access to it is a right and not a privilege.
Thirdly, medical conditions that develop due poor habits and lifestyle choices are avoidable and more of a privilege. Many of the so-called “diseases of affluence” that are becoming more and more prevalent in developed countries originate from modern people existing in a state of privilege. The poster child for this train of thought is a habituated smoker. Most people agree that the increased risk of smoking should not be publically subsidized.
In other words, if people are allowed the rights and freedoms to make their own poor health choices, then they are also fully responsible for the consequences that stem from them. Currently in the US, most health insurance policies charge more for people who smoke or are overweight and, therefore, are at a much higher risk of developing many illnesses. In sum, we can try to avoid prejudice and sympathize with people in many of these health situations. However, the rule of thumb here is that increased chance of morbidly due to avoidable risk-taking is a privilege, and therefore, coverage should not be socio-politically guaranteed.
Currently in the US, we have both manifest and latent forms of universal healthcare. Programs like Medicare, Medicaid, and the Affordable Care Act are manifest forms of universal healthcare. Tweaking what is currently in place to better negotiate the line between healthcare as a right and privilege is a good start. An important point to raise, however, is the latent form of universal healthcare that we currently have in place; the mandate that requires anyone visiting an emergency room to receive care despite their ability to pay.
This is an extremely reactive and inefficient model of healthcare that picks up the slack in places that the US has, so far, lacked the political will to address head on. Resultantly, hospitals have had to make up the cost by raising the prices of various forms of medicine in other areas. Many of the uninsured treatment that occurs in the emergency room would be considered a privilege by the standards described in the previous paragraphs. This leads me to believe that as a society we will need to look at two choices.
The first option is to stand firm on the principle that healthcare is not a right, repeal the current emergency room policy, and accept the increased suffering that would result. Contrarily, the second option is to collectively decide that it is, in fact, okay for people to receive certain medical procedures that fall in the category of a privilege, even if they cannot afford it. If we collectively choose to do this, then we should bring this latent universal healthcare out of hiding, and manifest it proactively with increased access to primary care.
In conclusion, simply stating, “I believe that healthcare is a right” is elevating political and personal opinion to a state of moral righteousness. This lacks sophistication, nuance, and should be avoided. However, one using the functionalist perspective can see that healthy people are productive and pay taxes while sick people do not. From an amoral, purely rationalistic, and economic view (that ignores metaphysical egalitarianism), it appears to make sense for the US to collectively universalize healthcare. This is because the human species requires a huge amount of investment – arbitrarily 26 years.
So, when it comes to negotiating the line between universalizing healthcare that is more of a right and leaving out that which is a privilege, I think that we should lean conservatively towards the side of universalizing healthcare. Lastly, writing this report has left me much less cynical. Now, I believe that, although our current healthcare system is not perfect and has many flaws. Yet, most of its flaws are the secondary consequences of good-willed attempts to negotiate the line between healthcare as a right and healthcare as privilege.
Works Cited
- Harris, Richard. “R&D Costs For Cancer Drugs Are Likely Much Less Than Industry Claims,
- Study Finds.” NPR, NPR, 11 Sept. 2017, www.npr.org/sections/health-shots/2017/09/11/550135932/r-d-costs-for-cancer-drugs-are-likely-much-less-than-industry-claims-study-finds .
- Introduction to Sociology 2e. (2016). Houston, TX: OpenStax College.
- Talks, TEDx. “Healthcare: Is It a Right or a Luxury? | Tarik Sammour | TEDxAdelaide.”
- YouTube, YouTube, 25 Jan. 2018, www.youtube.com/watch?v=jCVmY1iOJQs .
