Universal Health Care - Ethical Issues in Health Care Reform

Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed.

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government cannot know what is best for them. These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government's responsibility is to protect its citizens, sometimes even from themselves.

Two opposing arguments arising from two opposing ideologies. Both are good arguments but neither can be the supporting argument for implementing or denying universal health care. The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments than those already presented. Ethical issues would center on the moral right. Discussion would begin with not "What is best for me?" but rather "How should we as a society be acting so that our actions are morally correct?"

Ethics refers to determining right and wrong in how humans relate to one another. Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned with individual rights and freedoms.

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct. Here are some questions that could be used in ethical decision making for health care reform.

What action will bring the most good to the most people?
What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other?
What action in and of itself shows caring and concern for all citizens?
As the answer to all these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform. They are the only developed country without a national health care system in place for all citizens. They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere.

However, all ethical decision making is structured around values. In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

Beverly Hansen OMalley is a nurse with over 35 years experience in nursing education. She is health promotion specialist and is passionate about the necessity to address social determinants of health as part of overall health promotion strategies. She is the owner of http://www.registered-nurse-canada.com/index.html where she provides information on the Canadian health care system, the nursing profession in Canada, and the nursing entrance tests for the US and Canada.

by Beverly OMalley - May 3, 2009

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