The services and goods that citizens pay collectively include healthcare, national defense, law enforcement, national parks, and infrastructure such as bridges, public transport systems, roads, and railways. Private provision includes goods and services that one must buy for consumption. One has to provide for oneself services and goods such as groceries, cell phones, air tickets, and clothes.
Social or public goods and services include all the services and goods availed to community members typically provided by the government. The services and goods are funded through taxation. Purchasing private goods or services bars others from accessing the specific item, creating competition to acquire the service or good. Something should be paid for collectively when the service or good addresses the common societal need or is intended to ensure equity and efficiency. The government provides collective products for universal access. For instance, Biden’s move to expand health insurance targets ensures universal medical coverage access (Finkelstein). Private payment is essential for products and services that address personal preference needs, enabling market-driven purchases and meeting individual personal choices.
Comparison Between How Americans and the OECD Countries Pay for Healthcare
The majority of Americans rely on health insurance systems to fund healthcare services. Daniels considers the insurance schemes traditional, involving private and public insurance schemes. The Affordable Care Act (ACA) expanded Medicaid, developed health insurance marketplaces, and introduced subsidies to make coverage more accessible. The United States government’s 2019 expenditure on Medicaid was higher than $600 Billion (Finkelstein). The Medicaid coverage benefit costs Americans $5,500 per insured adult (Finkelstein). The U.S. has higher healthcare expenditure per capita than other OECD countries. The expansion has seen insurance coverage benefitting even uninsured Americans.
In OECD countries such as Germany and the United Kingdom, the government implements a universal healthcare system, allowing healthcare provision through highly regulated insurance markets or tax contribution payments (West‐Oram). Vital government roles in healthcare among most OECD countries allow effective implementation of universal healthcare. Unless in the U.S., where individuals fund healthcare through premium payments, many OECD countries have healthcare funded through taxation. The countries, however, have private insurance options as supplementary options. For instance, 10% of British citizens enjoy quicker access to healthcare courtesy of the private insurance sector in the country. At the same time, the rest of the population has to take more time to access the services through the British National Health Service (Daniels).
People Who Cannot Afford the Healthcare
Consider two cases of individuals who cannot afford healthcare. The first case involves Jerol Exson, who lacks the means to fund their healthcare needs. Jerol Exson’s condition occurred due to circumstances beyond his control. An unfortunate event happened without warning, rendering him incapable of working. Before the illness, Jerol was hardworking and capable of meeting the financial needs of healthcare.
The second case of John, whose illness arose from excessive consumption of alcohol, resulting in severe liver problems. John could ensure good health if only he chose to stop excessive drinking. Medical professionals had warned him on multiple occasions of the impending severe liver illness if he did not engage in risky behavior. Since they cannot afford their healthcare on their own, do their fellow citizens have a moral obligation to help pay for their healthcare?
The Theory Of Utilitarianism
The utilitarianism theory suggests that intervention outcomes determine morality. Wrong and right are best decided by assessing the outcomes of the choices and actions. In healthcare funding, a utilitarian approach would prioritize the option that maximizes overall well-being and happiness. A question arises of whether the net happiness would be highest when the people assisted their fellow citizens in meeting healthcare needs through taxes or if it would be higher if a combination of private insurance and government funding paid for healthcare. A utilitarian perspective would incline toward the universal healthcare system in Europe.
The universal healthcare system indicates higher happiness since it ensures equal access to healthcare and reduces the financial burden on low-income citizens. Daniels suggests that healthcare uniquely contributes to safeguarding equality of opportunity; thus, the priority should be enhancing opportunities for the citizens with the least opportunity. As presented in Gawande’s article, Arnold’s perspective argues that healthcare security is not only a personal responsibility but also a structure in the community for ensuring access to all citizens. Publicly funded healthcare ensures more equitable access to essential services, ensuring that a larger portion of the population has access to necessary medical care, contributing to a higher overall level of well-being in society.
Kant’s Moral Philosophy
Kant’s universal law formulation suggests that a moral act should be universally uncontradictory and applicable. Everyone must rationally and consistently apply the principle guiding actions without generating a logical contradiction. The formula of humanity indicates that a moral act must consider and respect individual autonomy and intrinsic worth. Kant’s moral philosophy considers imperative categorical when it represents universal, unconditional command applying to all rational beings irrespective of personal goals and desires.
Universalizing healthcare is compatible with Kant’s universal law when the services are offered equally to all citizens. Daniels notes that the quality of healthcare services is currently influenced by underlying societal inequality and social position. Universal healthcare should surpass biases and be consistent and rational without developing logical contradictions. Kant’s categorical imperatives force us to adopt universal healthcare schemes since ensuring access to healthcare for all is consistent with treating individuals with dignity and recognizing their intrinsic value. According to Rawls’s justice theory, a just society is characterized by equal value for all, equal basic liberties, limited inequalities to the least disadvantaged, and equal opportunity (Daniels). With this perspective, universal health schemes should be adopted.
John Rawls’s Social Contract Theory
John Rawls’s social contract theory is based on the premise of justice and is intended to develop a fair and just society. The theory proposes a hypothetical experiment: the “original position” behind the “veil of ignorance.” “The original position” provides an impartial and fair perspective to be implemented in reasoning regarding the basic principles of justice. The original position is a hypothetical scenario where individuals come together to create a social contract for their society. The “veil of ignorance” refers to conceptual factors that hinder individuals from knowing their circumstances and attributes in the original position. In the veil of ignorance, parties do not know their conceptions of good, historical, and social circumstances and characteristics, resulting in complete judgment impartiality. Behind the veil of ignorance, individuals know general facts but do not know specific details regarding their society and themselves. Rawls suggests the distribution of primary goods, including the social basis of self-respect, income, and liberties, to ensure equal opportunity (Daniels). Daniels’s argument extends Rawls’s argument to incorporate healthcare distribution.
Rawls’s Perspective on Healthcare Payment
Rawls’s argument suggests the distribution of resources to benefit the least advantaged members of society. This perspective supports the distribution of resources, including healthcare funding, to ensure that people who cannot afford the services acquire the services funded by the collective taxpayers. The target of the argument is fair opportunity for all, including the vulnerable in society (Daniels). Citizen’s obligations to assist each other in meeting healthcare needs align with promoting the well-being of the least advantaged in society.
Conclusion
Whether Jerold Exson and John will have their fellow citizens pay for their healthcare or pay on their own can be analyzed using several theories. The argument delves into the broader debate surrounding healthcare as a public good and whether society should prioritize collective responsibility for the well-being of its members, irrespective of the circumstances that led to their health issues. The utilitarian perspective would support payment of healthcare services for both individuals to ensure maximum overall well-being and happiness.
The two versions of Kant’s categorical imperative recommend rational and consistent actions applicable to all individuals without a logical contradiction, emphasizing the inherent value and dignity of every rational being. Applying the Kantian perspective would mean that both individuals have equal access to medical services funded by the taxpayers to promote universal respect of individual intrinsic worth and consistency. Equal treatment promoted by Kantian argument does not differentiate individuals on the cause of illness. Drawing argument from Rawls’s social contract theory still supports that the two individuals have their healthcare services paid by other citizens’ taxes. Other citizens’ taxes would ensure that Jerold and John acquire medical services since the social contract theory targets maximizing the well-being of the least advantaged in society.
Work Cited
Finkelstein, Amy. “Why Cash Is Better than Expanded Health Insurance for the Poor.” The New York Times 13 May 2021. Web. <https://www.nytimes.com/2021/05/13/business/health-insurance-cash-Biden.html>.
Daniels, Norman. “Justice, Health, and Healthcare.” American Journal of Bioethics, vol. 1, no. 2, Feb. 2001, pp. 2–16. <https://doi.org/10.1162/152651601300168834>.
West‐Oram, Peter G. N. “Solidarity as a National Health Care Strategy.” Bioethics, vol. 32, no. 9, May 2018, pp. 577–84. <https://doi.org/10.1111/bioe.12443>.
Gawande, Atul. “Is Health Care a Right?” The New Yorker, 25 Sept. 2017, <www.newyorker.com/magazine/2017/10/02/is-health-care-a-right#:~:text=It’s%20a%20question%20that%20divides,possible%20to%20find%20common%20ground.&text=September%2025%2C%202017-,Is%20health%20care%20a%20right%3F,to%20agreement%20on%20an%20answer>.
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