Health Care Reform
There is broad agreement that our current health care system is simultaneously expensive, inequitable, and wasteful, and that escalating health care costs and the erosion of private insurance coverage are seriously undermining the health and economic security of all Americans. There is also agreement that, as a society, we can provide affordable health care to all our citizens—as all other Western industrialized democracies do—and many believe that this fact alone supports the moral argument that we ought to do so. This volume focuses on the importance of establishing a right to health care as a necessary step in assuring universal access.
The language of rights is useful in highlighting the inequities and inadequacies of our current system, and in organizing public support for reform in general. It is also useful in helping to define the broad parameters of a system that can assure a right to health care. However, in determining the myriad details in the design of this system, it may not prove useful as an operational guide, for it raises as many questions as it answers. How much health care? What quality health care? What is the responsibility of individuals for their own health? 1 Just as importantly, it is unlikely that the language of rights will be helpful in reaching consensus among the many players in the health care reform debate, consensus that is essential if comprehensive reform is to be enacted. This is seen clearly in a telling exchange between two physicians at a discussion on health care during a meeting of a physician's association in the 1970's. While one physician stated that every person in the country had an "inalienable right to the very best in health care", the response from another was, "they may have that right, but they don't necessarily have the right to get it from me." 2
In the United States today there is already a limited—albeit insecure—right to some health care for the majority of the population. There is also an absolute entitlement to some health care through