Healthcare epitomizes perhaps the most pronounced intersection around policy, economics, and social welfare, all woven together with the intrinsic substratum of central moral/ethical value pervasive throughout society. At the heart of the political debate concerning universal health care is one essential and strikingly moral question: What does society owe each citizen regarding healthcare? This essay examines the ethical underpinnings of universal health care. “Equipoise,” when grounded in such truths as “justice” and “human dignity,” buttressed on said equal principles, may mean that Universal Healthcare is not for presentation before the people as a snippet of privilege but instead as an inalienable right. I will argue that universal health care is a fundamental moral and ethical right because it embodies principles of Utilitarianism, deontological ethics, and consequentialism, ensuring equitable access to healthcare for all individuals regardless of their economic status, thus promoting societal well-being and justice. When taken together, such arguments clearly announce the need for such a system whereby universal access to healthcare is available to secure the well-being of certain sections of society regardless of their economic standing. In consideration of this, the primary aim of the paper
Ethical Issue Description
Deep Dive into Universal Healthcare Ethics
An ethical necessity in universal healthcare supposes that taking care to access medical services speaks more than just speaking about it dynamically. However, humanity is also put at the forefront, treating one another morally (Robinson & Doody, 2022). Justice becomes crucial, especially distributive justice because it questions how health resources are appropriated and challenges market-driven models in allocating access to them, through which health access is mainly gauged by one’s ability to pay. A second example comes from the Scandinavian countries with universal health systems, based on the re-distributional equity of health care delivery—very much against those systems where health is considered a commodity. It reflects a warrant of dignity so that society attaches much importance to it as a protection of every member, emphasizing an ethical position where, regarding health care, every person is obliged to receive it as a right, not a privilege.
Broader Moral Literature Embedding
Major ethical theories support arguments for universal health care. For example, Utilitarianism as a theory supports actions that lead to the most significant amount of happiness for the greatest number; health is said to give universal access because improved population health outcomes increase happiness and productivity for society. Deontology ethics is based on the philosophies of Immanuel Kant. They equate duties with rights, holding that human beings have a right to health care as health holds some intrinsic value in human life. Also, the Universal Declaration of Human Rights echoes this noble statement: On the other hand, virtue ethics relates to the character, particularly the virtues of an individual, and a fair society, thus meaning a developed value of virtue (Streich, 2019). The translation on this very ethics angle is that of a healthcare system available to all, where cooperation aids in the building of a culture of empathy with mutual care. Universal healthcare is one way of providing the good life for Aristotle because it entails the health and welfare of people and the community.
These ethical frameworks argue that universal care is a moral imperative beyond another set of policy preferences (Doherty & Purtilo, 2021). The meaning of equity in the health domain ought eventually to lead to an opportunity to leave the commodification of health behind and to rediscover it more as a public good. This right is equitably accessible by all people and does not depend on SES. It is through that more considerable moral literature, inclusive of things such as the principles for human rights and development, that one appreciates universal health coverage to be not just an entitlement but the mirror reflection of the very seriousness the society is supposed to accord regarding the dignity and well-being of each member within it.
Charitable Reconstruction of the Opposing Argument
One of the main arguments against universal health is grounded in its possible adverse effects on the efficiency and quality of healthcare delivery (Mitchell et al., 2019). The systems will likely be overrun and flooded with increased demands that take away medical resources since making health care universally more accessible. They further postulate that with this kind of market-driven healthcare, there will always be a competitive environment through which the imagination and creativity of healthcare givers and corporations are brought into play, ensuring operability and resulting in innovative and better results for their operations. Such competition will be an impetus for developing new treatments and technologies. There is also the further argument that real competition and choice would operate to make quality high, an argument that is set aside and immobilized by the exigencies of a universal service model. In market-driven settings, providers are highly incentivized to bring excellence and compete through differentiation to attract and keep patients.
Universal health care, a coverage policy, encompasses all its citizens. This policy is a libertarian view through which people are expected to have autonomous rights and self-determination regarding their health care (Burstrom, 2022). Critics argue that this compulsory imposition of universal health care violates individualism and that the state’s role in health provision has become overly patronized. The nature in which universal health care is constructed to work is tantamount to the loss of choice and personal freedom. This essay agrees with such an assertion. In framing the argument in such terms, it has already been granted that the critics’ arguments are legitimate fears of what might occur if universal health care emerged. It is immediately recognizable by such a fair presentation that it lends itself to nuanced discussion, critical engagement with anxieties, and discussion against the harmonious backdrop of the ethical imperatives and empirical strengths that advocate universal health care.
Empirical Evidence
A punitive body of empirical evidence from countries that have gone universal in healthcare insists that universal healthcare is not only possible but fundamentally better in advancing public health, economic efficiency, and the well-being of society (Murthy & Ansehl, 2020). Other nations known to have universal access systems, such as Sweden, Denmark, Canada, and the United Kingdom, always lead the nations that have not adopted universal care in life expectancy, survival rate, and success in preventing diseases (Mbanya et al., 2020). These are the best public health successes directly attributed to the inclusivity of access to health services under universal systems. In contrast, healthcare models do not offer services to all people depending on their money; in Universal Health Assurance, citizens get timely and necessary medicine for treatment or prevention, mandating people to communicate with others in case of infectious disease outbreaks. Such a caring approach ensures that citizens’ health is improved when the time demands it. There, there is a commitment to exercising equity and justice regarding the benefits of good health.
Besides, the expenses of the universal health care system have proved to be much more effective when compared with the market-based one. For instance, in The United States, the administrative costs of health care are far above those of countries practicing universal health care (Tohid & Maibach, 2021). This effectiveness shows high levels of efficiency through the most straightforward provision of care by the universal systems, whereby the administrative overhead is lowered through centralized planning and negotiation. Besides, universal systems are distinguished by equal distribution to ameliorate societal disparities in the access to healthcare services and the benefits they acquire. Through equality in access and outcomes to services, health systems avoid further disparities in people’s health statuses from income disparities, jobs, or geographical locations. If not the epitome of the principles of justice and equality, the systems embody the same to the letter. The holistic paradigm on health, as perceived in the idea of health conceived as a public good but not a market commodity, further solidifies the moral and ethical underpinnings of advocacy that health services should be given to everybody, accentuating health in realizing a just and fair society.
Global Case Studies of Universal Healthcare Systems
It was just that the implementations pointed out for universal healthcare in the offering nations showed tangible results that reflected and represented the embodiment of the core ethical principles of this essay: equity, justice, and human dignity. Great examples of the UK’s National Health Service (NHS) bear witness to this fact. Healthcare is accessible to the consumers at the place of use, as it is levied through taxation. This single-payer model is highly revered for its expansiveness and the spirit of societal solidarity it encapsulates (Cohen, 2021). Equally, it needs to work on extensive waiting periods for almost all kinds of treatments and economic aspects. The multiplayer system in Germany produces equity by merging public and private sector involvement to titillate many options available to its citizens. This system assures quality care as it has recorded impressively high rates of patients’ contentment, proving that flexibility and choice could coexist as long as the ultimate framework could guarantee universal access. The model of universal health care in Canada and the Scandinavian countries emphasizes cost controls and access to care. Many of the examples from all over the world show how the successful approaches toward universal health are diverse and have different characteristics in their identifications of how the equity considerations balance towards the ethical imperatives and sustainability of health care delivery.
These global cases herein will not only provide examples of the possible reality of universal health but also examples of the different ways through which the other nations maneuver their health provisions. For example, how to deal with funding or waiting time issues—NHS targeted reform has exhibited investment in health care infrastructure in maintaining or improving quality and efficiency. This model also suggests that Germany’s example demonstrates how it is possible to maximize patient choice and satisfaction and to deliver health care universally to all—offering suggestions for how other countries can improve their healthcare systems without losing that essential trait of fairness and access. The Canadian and Scandinavian experiences with cost containment while ensuring universal access should highlight the significance of sustained political will and public investment in health care (Colton, 2019). Each case study reflects various lessons and best practices in areas such as administrative efficiency and embedding preventive care, which can be illustrative and inspirational in any efforts toward optimizing health systems under universal health care worldwide.
Besides, these healthcare systems have also significantly impacted health and social cohesion. Statistically, life expectancy, infant mortality, and the prevalence of chronic diseases have significantly improved in these countries whose health care is under universal health coverage. However, far more than the health outputs, universal health care builds a sense of shared responsibility and togetherness that sharpens social bonds and underlines health as a public good of society (Sacks et al., 2019). However, the efforts to create an ideal healthcare system have been continued in the direction where each country does have its difficulties—the ability to be financially sustainable, adapting to demographic shifts, including the rising population of older people and more people living with chronic non-communicable diseases, and learning to change with advances in technology. The processes of learning, adjusting, and improving were first born through this academic level from this ethical commitment to universal healthcare, where they always keep showing their practical aspect in the evolution toward systems that ensure the meeting of healthcare needs not only for people today but also for the people of the future.
Evaluating the Opposing Argument
Critics of universal health care usually base the center of their attacks on seen inefficiencies, a loss in quality care, and the stifling of innovation. Universal critics of health care argue that, in the case of the United States, the system could become like that of Canada, where quality care is not widely available. As a case in point, the performance rankings of the World Health Organization typically feature Universal Healthcare nations at the top, only lending a loud indication that the high efficiency and quality of attention is indeed both attainable and reached (Takura & Miura, 2022). Buffing such evidence runs directly counter to the argument predicated on the notion that by the nature of the case, Universal Healthcare becomes a route to inefficiency and poor quality of care. Arguments about wait times often cloud the core difference between elective procedures and urgent care, but all evidence and statistics considered, those of us in universal care systems generally have vastly superior experiences since both systems have similar records of immediate medical needs.
Besides, this works against a view that has a straightforward explanation for the complex medical research, the number of factors that drive healthcare advancements, and allowing the innovation of health in the private sector based on other matters like collaboration, public funding, and academic research most of which are robust in countries that practice universal healthcare. Many such countries deliver contributions that are medically advanced on a worldwide scale and serve as evidence that the funding system for the model of delivering healthcare does not determine the ability to be innovative (Horgan et al., 2020). This signals proof that, generally, in the case of such states, it may be possible to build a stable platform for innovations and universal access to the latest means of treatment and technologies. In targeted reform and investment in digital health infrastructure, and most critically, the new reemergence of focus on patient-centered care models and a multitude of challenges that are obstacles standing in their way, universal health systems are—or can and do—consistently surmount to be on a continuous unprecedented rise and improvement to cater to the varied needs of the people.
Rebuttal and Ethical Justification for Universal Healthcare
Critics of state provision of health care in any form, not just universal provision, usually appeal to values of individual freedom and choice. Market-driven health systems proffer that they naturally assume the promotion of competition, innovation, and quality care arising from consumer choice (Moffit & Fishpaw, 2023). They argue that since a patient can choose health care providers, the latter will be assiduous innovators, excelling at attracting and then keeping patients. This choice is, of course, said to honor and protect the notion of the freedom of the atomistic individual; however, if such a claim is made, several variations insofar as the number of choices and the opportunities presented in such market-driven systems are ignored if not altogether taken for granted. In all of the truthfulness, the choice itself is a sellable and free good that discriminates against many individuals the world over simply because many individuals cannot afford it. Probably something of the nature of a health care system that assures excelled universal health care can assure ethics given that such services ensure that access is leveled and whose basis is only on the platform of need but not monetary capabilities, thereby practicing the ethical principle of equity and justice toward all people.
Disapproving universal healthcare yet celebrating the stifling of medical innovations does not add up. Meanwhile, universal healthcare has been shown, all across the board, to showcase a lead in most medical research and innovation (Van Niekerk, Manderson, & Balabanova, 2021). This leading has been due to the substantial public investment and focus on unyielding ways that show results. As building up from free health services in countries like the United Kingdom and Sweden for their countries in general, even technological and pharmaceutical novelties, whose prices can reach very high, sometimes into millions of dollars for the entire treatment and compensation for the invested inventing and testing efforts are free and accessible worldwide. These free health services are formal since the system makes all the new treatments and technologies suddenly available to all, thus letting the fruits of innovation reach the entirety of a country and not just its privileged economic part. However, health innovation democratization reiterates ethical commitment—the two commitments above are to maximize public benefits concerning health and to secure equal access to the latest significant strides in medical progress.
What needs to be addressed in general dialogue regarding healthcare models is that there is often an all-but ultimatum given to choosing between healthcare models regarding individual autonomy versus collective well-being. However, several universal healthcare systems abroad, such as in France and Japan, prove that it is feasible to build elements of individual choice and market competition into a system ensuring access for everybody (Gusmano et al., 2021). Again, these countries prove it with class and can achieve it quite elegantly by addressing many of the regular health market failures, such as the information gap between providers and patients and the public good nature of health. Mechanisms in securing universal health care are based on values emphasizing solidarity, equity, and the common good. Care is situated not as the nature of business but rather as a moral and ethical responsibility to each of its members to ensure that decisions related to health are channeled by conditions related to public health and social justice and not profit.
Conclusion
It is designed to show readers the B side of the ethical landscape that universal healthcare is not viable and realistic. Indeed, universal healthcare could be more viable and realistic. For example, it is a caregiver in itself. The essay has demolished that view, showing that questions raised by opponents were misplaced by a critical look at opposing standpoints supported by empirical evidence from countries that have implemented universal health coverage and brought in its viability, efficiency, and contributing factors to society’s welfare. While this is easily granted, health systems can be complex and pose several formidable challenges. Universal health care—ensuring access to equal health service and innovation for the common good as a matter of ethical imperative of societal solidarity—remains persuasive. Future research is needed to delineate further studies on optimization in these systems for more efficiency and integration of state-of-the-art technologies towards better health needs, compared to results that are more towards validated economic and health outcomes in the benefit of universal health models. This inquiry solidifies the moral need for universal health—not to make it only an ideal and utopia, but an actual goal closer than it might appear, complementary to attaining a just and fair society.
References
Burstrom, B. (2022). Aiming for Health Equity: The Role of Public Health Policy and Primary Healthcare Comment on “Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare.” International Journal of Health Policy and Management, 11(5), 714–716. https://doi.org/10.34172/ijhpm.2021.112
Cohen, S. (2021). NHS, the Britain’s National Health Service, 1948 -2020. Shire Pubns.
Colton, D. (2019). The case for Universal Health Care. Clarity Press, Inc.
Doherty, R. F., & Purtilo, R. B. (2021). Ethical dimensions in the health professions. Langara College.
Gusmano, M. K., Laugesen, M., Rodwin, V. G., & Brown, L. D. (2020). Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs (Millwood, Va.), 39(11), 1867–1874. https://doi.org/10.1377/hlthaff.2019.01804
Horgan, D., Metspalu, A., Ouillade, M.-C., Athanasiou, D., Pasi, J., Adjali, O., Harrison, P., Hermans, C., Codacci-Pisanelli, G., Koeva, J., Szucs, T., Cursaru, V., Belina, I., Bernini, C., Zhuang, S., McMahon, S., Toncheva, D., & Thum, T. (2020). Propelling Healthcare with Advanced Therapy Medicinal Products: A Policy Discussion. Biomedicine Hub, 5(3), 130–23. https://doi.org/10.1159/000511678
Mbanya, V. N., Terragni, L., Gele, A. A., Diaz, E., & Kumar, B. N. (2020). Barriers to access to the Norwegian healthcare system among sub-Saharan African immigrant women exposed to female genital cutting. PloS One, 15(3), e0229770–e0229770. https://doi.org/10.1371/journal.pone.0229770
Mitchell, P., Cribb, A., & Entwistle, V. A. (2019). Defining What is Good: Pluralism and Healthcare Quality. Kennedy Institute of Ethics Journal, 29(4), 367–388. https://doi.org/10.1353/ken.2019.0030
Moffit, R. E., & Fishpaw, M. (2023). Modernizing Medicare: Harnessing the power of Consumer Choice and Market Competition. Johns Hopkins University Press.
Murthy, P., & Ansehl, A. (2020). Technology and global public health. Springer.
Robinson, S., & Doody, O. (2022). Nursing & Healthcare ethics. Elsevier.
Sacks, E., Morrow, M., Story, W. T., Shelley, K. D., Shanklin, D., Rahimtoola, M., Rosales, A., Ibe, O., & Sarriot, E. (2019). Beyond the building blocks: Integrating community roles into health systems frameworks to achieve health for all. BMJ Global Health, 3(Suppl 3), e001384–e001384. https://doi.org/10.1136/bmjgh-2018-001384
Streich, M. (2019). The Universal Declaration of Human Rights. Spinebill Press.
Takura, T., & Miura, H. (2022). Socioeconomic Determinants of Universal Health Coverage in the Asian Region. International Journal of Environmental Research and Public Health, 19(4), 2376-. https://doi.org/10.3390/ijerph19042376
Tohid, H., & Maibach, H. (2021). International Medical Graduates in the United States: A Complete Guide to Challenges and Solutions (1st Edition 2021). Springer International Publishing AG. https://doi.org/10.1007/978-3-030-62249-7
Van Niekerk, L., Manderson, L., & Balabanova, D. (2021). The application of social innovation in healthcare: a scoping review. Infectious diseases of poverty, 10, 1-25.
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