What is a right? A right is a perceived entitlement based on legal, social and ethical principles that is owed people according to law, social convention, or ethics (Reisch & Weil, 2013). A privilege is a special advantage not enjoyed by everyone (Carel & Kidd, 2014). Based on the aforementioned definitions, health care is not a basic right in the United States but privilege.
Based on our current societal norms, health care is a commodity or a service that must be purchased, therefore having the ability to pay for healthcare is privilege. Because doctors can deny patients care based on insurance, further denies that health care is a right. Rights are accepted and undeniable entitlements afforded to all members of a society (Reisch & Weil, 2013).
Even with the recent adoption of the Affordable Care Act, which attempts to provide the right to health care for all Americans, many citizens cannot burden the cost of health insurance (Arras, 2014). Therefore, access to care is afforded only to those who have the privilege of being able to pay the tribute (Carel & Kidd, 2014). Neither the Constitution nor the Bill of Rights guarantees healthcare; however, the government entitles health care to only the elderly, the young, and impoverished- thus alienating the rest of American society (Reisch & Weil, 2013). This stratification and separation of citizens’ access to entitlements creates a seemingly unjust and unfair society wherein the majorities who pay for health care through taxes do not have access to it (Barker & DeNisco, 2013).
Health care is not a right in America because beneficence in not in the Constitution (Orentlicher, 2012). Health care as a given right is seemingly paternalistic and creates a dependency that runs counter to the American values of individualism, self-reliance and independence. But just because health care is not included in the founding documents does not make its omission morally correct (Orentlicher, 2012). The Constitution is not static but a fluid template to help guide and govern the nation (Orentlicher, 2012). Therefore, the Constitution can and must be amended to suit the needs of current society (Orentlicher, 2012). In this egalitarian society, privileges for segments of society are not ethical and right. Therefore, the guaranteed limited privilege for a limited portion of American society must be extended as a right for all to be an equal and just society.
As nurses it is our duty to care (Barker & DeNisco, 2013). But we must extend this moral and professional obligation so that Americans can receive care or have care available if they so choose to accept it. As a profession we must lobby and advocate for changes in laws and legislation so that all people have the right to receive health care without stipulations and limitations.
In a recent publication, United Healthcare has announced its withdrawal from the ACA exchange system (http://acasignups.net/16/04/19/updated-unitedhealthcare-lowers-boom-pulling-out-exchanges-most-states-expected. They state they have lost billions of dollars. This raises some ethical issues. Health care is not money making venture if it attempts to provide access to a majority of the population. It simply cannot be done. That is why any societies with universal coverage have governments controlling health care. Simply put, health care management is only profitable if the money given by the consumers exceeds the costs of the services provided by the organizations. This only works when the consumers do no use the service and pay large amounts for the potential to use those services. But unfortunately if provided on a grand scale, health care will be utilized by the entire population at some point, especially towards the later years of life when health care will be continually be used (Wister & Speechley, 2015). Therefore, health care is a money pit and I understand the reason for United Healthcare’s move- not that I necessarily agree with it but I understand their reasoning.
- Arras, J. D. (2014). The right to healthcare. The Routledge Companion to Bioethics, 3.
- Barker, A. M., & DeNisco, S. M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession (2nd ed.). Boston: Jones & Bartlett. ISBN 13: 978449665067
- Carel, H., & Kidd, I. J. (2014). Epistemic injustice in healthcare: A philosophical analysis. Medicine, Health Care and Philosophy, 17(4), 529-540. 40. doi: 10.1007/s11019-014-9560-2
- Orentlicher, D. (2012). Rights to healthcare in the United States: Inherently unstable. American Journal of Law & Medicine, 38(2-3), 326-347. doi:10.1177/009885881203800205
- Reisch, M.J., & Weil, M. (2013). Social justice, human rights, values, and community practice. The handbook of community practice, 73-103.
- Wister, A. V., & Speechley, M. (2015). Inherent tensions between population aging and health care systems: What might the Canadian Health Care System look like in twenty years? Journal of Population Ageing, 8(4), 227-243. doi: 10.1007/s12062-015-9123-1