Is this gift returnable?

I gave an impromptu lecture to a class full of medical students about the American health care system a couple of weeks ago. The biggest reaction seemed to be their disbelief that there is no legal right to health care in the American constitution. Government obligation to health care is part of Argentina’s constitution and the country has also committed to a number of human right declarations and treaties.

Argentina spends the most per capita on health care in South America and the United States has the highest per capita spending on health care in the world. Despite the high level of spending in both, neither country has a health system that protects the people it is meant to serve. Disruptions in medical supplies and medication and lack of transparency in bureaucracy interfere with health care for Argentines. Until two months ago, a program of the national Ministerio de Salud provided a box of food each month to indigent families who had an least one family member with a chronic illness. This included many of the patients that come to the clinic that I work at. However, without warning the program has stopped, leaving many families without food in a time of high consumer prices and cold weather.

The United States health care system is no stranger to leaving people out in the cold when programs suddenly end. I can use my home state of Texas as an example. One of the most immediate problems in 2003 was a budget shortfall of almost $10 billion dollars. The legislature cut funding across the board to reduce costs but one of the most severe cuts was to the CHIP program, which provided insurance coverage to children of working families who can not afford insurance. This budget cut was proposed in spite of a offer for over $200 million in matching funds from the federal government. To make matters worse, the legislature also passed stricter guidelines for eligibility. For the 200,000 children that lost coverage under CHIP, there was no safety net save for emergency room visits.

Both examples are similar in that the government committed to providing a service that promoted the wellbeing of the people who benefited from the services. I do not think that are doubts about the harm suffered by the people affected by the sudden abandonment. Are government health programs an entitlement or a privilege? Does the government have a moral obligation to continue providing a service that contributes to health even without a legally defined right to health care? And if not a moral obligation, is there another standard that determines the strength of the obligation?


3 comments so far

  1. Summer Fey Foovay on

    The situation in the United States as regards medical care is shameful. Over half our population has no insurance. I, personally, have been turned away from an emergency room because I had no insurance. The message was “go home and die quietly, or we’ll have security remove you”. Good medical care is ONLY for the wealthy. Poor people can either learn self-care or die young. Preferably before their usefulness in the work force is over. The medical care that is available, thanks to Big Pharm and AMA focuses on sickness, not wellness. Rather than treat the underlying cause and cure, they’ll put you on medication that has it’s own side effects and then medication for those and then…so that you are locked into regular doctor visits and costs of prescription medicine. The doctor makes money, the drug company makes money, poor or middle class people live miserable and die young. What’s not to love? As long as we allow the corporate interests to run our government we will not have socialized health care or universal insurance or anything else that guarentees that our worlds greatest medical care trickles down to the regular citizens of our country.

    I could go on and on, this is a huge pet peeve of mine. I’ve watched one too many people die for lack of proper care, which they did not get – not because it isn’t available, but because they were not rich or well insured.

  2. Tim Weaver on

    It’s embarassing to live in the nation leading the “free” world when we’re so many years behind the rest of the west on healthcare.

  3. Vanessa on

    @Summer I’m sorry to hear that you were turned away from an emergency room for lack of insurance. It’s actually illegal for them not to treat you. There are a lot of factors that have contributed to how our health system works (or doesn’t work). I wanted to use this blog to explore health not only in the United States but also in other countries.

    @Tim At this point I’m worried less about our international reputation as regards health care. I would rather turn our attention to the people that the system lets down on a daily basis. They are the ones who are suffering.

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