National Health Care By: Barbara LeBlanc

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National Health CareBy Barbara LeBlanc
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Introduction

• U.S. consumes more than 1.5 trillion in GDP
  annually (Williams)
• 45 million (15 of) U.S. citizens with health
  care coverage
• Case Study 40 year-old, Kimberly Cecil
  (Courier-Journal.com)
• How many other U.S. citizens are in Kimberlys
  situation?
• The government must step in, but what should they
  do?

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Thesis

• It is immoral for the U.S. government to allow
  the current health care system to maintain the
  status quo. Instead, it ought to reform the
  current system based on Aristotles Doctrine of
  the Mean.

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U.S. Health Care System

• The United States is the only industrialized
  nation that does not utilize a national health
  care system
• Loosely defined system (Health Systems)
• Insurers, providers, employers
• Citizen tax dollars are utilized to finance
  government programs
• Medicare, Medicaid, VA
• Health coverage among people in the U.S. is not
  uniform across the board
• Some have insurance through employer
• Some (those who can afford) may purchase their
  own
• Other go without coverage due to the cost
• Costly premiums (Barackobama.com)
• Health insurance premiums have doubled in the
  past eight years rising faster than wages, and
  contribute to over half of all personal
  bankruptcies today caused by medical bills

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Moral Concern

• The current U.S. health care system is in
  violation of citizens
• Moral right to (human) life
• All persons have a moral right to physical and
  behavioral health care. Access to basic health
  care is a fundamental human right, necessary for
  the development and maintenance of life and for
  the ability of human beings to realize the
  fullness of their dignity (Health Care is a
  Safeguard and a Right to Moral Life)

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Moral Concern (continued)

• The current health care system under the managed
  care program contributes to and is responsible
  for the increasing number of uninsured citizens
• According to the Department of Social Medicine,
  University of North Carolina at Chapel Hill, USA.
  churchill_at_med.unc.edu
• Describing the U.S. health care system means
  describing managed care under commercial forces.
  Managed care creates new moral tension for
  practitioners, but more importantly, in its
  current form it intensifies the commercialization
  of health expectations and interactions. The
  largely unregulated marketing of health services
  under managed care has been a major factor in the
  increasing number of uninsured citizens, while
  claims for cost reduction through managed care
  are equivocal. Risk-rating practices integral to
  the current medical marketplace thwart concerns
  for justice in allocation and create
  vulnerabilities for almost everyone.

(The United States Health Care System Under
Managed Care. How The Commodification Of Health
Care Distorts Ethics And Threatens Equity. )
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Aristotle

• Ethics, as viewed by Aristotle, is an attempt to
  find out our chief end or highest good Such a
  chief end is universally called happiness
  Happiness is
• Based on human nature
• Gained from facts of personal experience
• Lies in the active life of a rational being
• Expands his notion through analysis of the human
  soul
• (Aristotle (384-322 BCE) Overview)

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Aristotle Part of the Human Soul

• Irrational shared with animals
• Rational distinctly human
• Purely the rational part of the soul which gives
  one intellectual virtue and the ability to
  contemplate, reason logically, and formulate
  scientific principles
• Rational and irrational
• Responsible for controlling ones emotions and
  desires (grief, hope, joy, fear)
• Together create moral virtue and the focus of
  morality
• (Aristotle (384-322 BCE) Overview)

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Aristotle Moral Virtue

• Is not instinctive, but learned
• Too much / too little regulation creates problems
  (e.g. The Doctrine of the Mean)
• Are character traits

(Aristotle (384-322 BCE) Overview)
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Aristotle Doctrine of the Mean

• Moral virtues are desire regulating character
  traits which are at a mean between more extreme
  character traits (or vices).
• Determined by situation
• Develop an excessive character trait vice of
  excess
• Develop a deficit character trait vice of
  deficiency
• The Mean lies between the excessive extreme and
  the deficit extreme
• The mean is rationally determined based on the
  relative merits of the situation
• Finding the mean in any given situation is not a
  mechanical or thoughtless procedure, but requires
  a full and detailed acquaintance with the
  circumstances

(Aristotle (384-322 BCE) Overview)
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Aristotle Doctrine of the Mean

• The mean is rationally determined based on the
  relative merits of the situation. In this case,
  what are the basic health care needs of each
  citizen
• Affordable care
• Accessible care
• Quality of care
• Flexibility in health care choices
• Prevention (e.g. regular screenings)

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Application of The Doctrine of the Mean

• The Mean as it pertains to health care must
  determine a solution that moves our country away
  from the current system and into a reformed
  system that ensures health insurance/coverage for
  all
• Proposed health care reform
• The Center for Health Transformation (CHT)
  founded by former Speaker of the House, Newt
  Gingrich has a movement in place to
• Accelerate the adoption of transformation health
  solutions and policies that create better and
  more choices at lower cost
• The CHT is dedicated to creating a 21st century
  intelligent health system one that is aimed to
  save lives and money for all Americans
• The goal of this 21st century plan is to provide
• 100 coverage for all, ensure individuals have
  access to the best information to maintain their
  health, improve health outcomes, improve the
  quality of life leading to longer lives at lower
  cost
• Members of the GOP Doctors Caucus, a forum of
  Republican physicians for the 111th Congress are
  also working on health care reform to
• Discuss solutions to improve access to quality
  health care that is patient-centered,
  patient-driven focused on affordability,
  portability and choice in health care

(Center for Health Transformation) (Gingrey,
Murphy Form GOP Doctors Caucus)
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Counter Argument

• John Stuart Mill Principle of Utility
• Actions are right in proportion as they tend to
  promote happiness wrong as they tend to produce
  the reverse of happiness
• We must choose the policy that has the best
  overall results for everyone
• As far as possible from pain
• Rich as possible in enjoyment
• Utilitarianism focus solely on the consequences
  of a an action
• Does not take into account ones own self
  interest but instead the interest of others over
  ones own
• Greatest good for the greatest number
• (John Stuart Mill Overview)

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Counter Argument

• Jeremy Bentham Principle of Utility
• Recognized the role of pain and pleasure in human
  life
• Approves or disapproves of an action on basis of
  the amount of pain or pleasure brought about
  (e.g. consequences)
• Equates good with pleasure and evil with pain
• Asserts that pleasure and pain are capable of
  quantification (e.g. measure)
• Measuring pleasure and pain, Bentham introduces
  the following criteria
• Intensity, duration, (un) certainty,
  nearness/farness
• Actions that affect numbers of people, we must
  account for its extent

(Utilitarian Theories)
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Application of the Principle of Utility

• Revamping the entire U.S. population into a newly
  formed health care system may appear to be the
  best answer for all, however conversion will not
  be without pain (As of now, the government has
  not provided clear answers)
• Application of Jeremy Benthams criteria to
  health care reform
• Intensity
• How can the government feasibly ensure all
  citizens have medical coverage?
• Duration
• How long is a citizen able to utilize the 21st
  century health care system?
• Are there age requirements?
• Uncertainty
• Who will pay for the health care reform?
• Will American taxes go up to pay for the new
  system which ensures all citizens health care
  coverage?
• How will the government go about converting all
  citizens to a new system?
• How will the government ensure all citizens
  receive the coverage they are promised?
• Will citizens have the ability to choose their
  doctor?
• Nearness/farness
• How long will it be before the government acts to
  instate health care reform?
• Extent
• To what extent will citizens be covered?
• What if a citizen has a pre-existing condition at
  the time of conversion?

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Disproving the Principle of Utility

• At this time, the government has not provided
  clear answers to the feasibility of a health care
  reform.
• Health care reform should not be viewed as a
  means to happiness, but as The Mean itself
• The government will not make 100 of the U.S.
  citizens happy by keeping the current system or
  reforming it
• There is not a one-size fits all solution, but
• Reform is the best solution
• As previously stated
• The Mean is determined based on relative merits
  to the situation
• Each U.S. citizen is valuable and should be
  afforded the moral law of Right to (human) life
• Finding the mean for health care reform is not
  a mechanical or thoughtless procedure, but
  requires a full and detailed acquaintance with
  the circumstances
• The government must put together a strategic plan
  and methodically lay it out to ensure accessible,
  affordable, and quality health care coverage for
  all

(Aristotle (384-322 BCE) Overview)
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Conclusion

• The current U.S. health care system is broken
• Immoral for U.S. government to allow our current
  program to continue
• Current U.S. health care system in need of reform
• Strategic plan must be implemented to ensure the
  Right to human life and affordable, accessible,
  quality health care for all citizens in America

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References

• Affordable, accessible coverage options for all
  (pg 6). (n.d.). Barack Obama and Joe Bidens Plan
  to Lower Health Care Costs and Ensure Affordable,
  Accessible Healthcare Coverage for Aall.
  Retrieved February 7, 2009, from
• http//www.barackobama.com/pdf/issues/HealthCareF
  ullPlan.pdf
• (slide 4)
• Aristotle (384-322 BCE) Overview. (2006).
  Retrieved January 24, 2009, from website
  http//www.iep.utm.edu/a/aristotl.htm
• (slide 7 10, 16)
• Center for Health Transformation. (n.d.). About
  the Center. Retrieved April 16, 2009, from
  website http//www.healthtransformation.net/cs/tr
  ansforming_healthcare
• (slide 12)
• Courier-Journal.com. (2008, July 20). As Health
  Insurance Premium Rises, Working Mom drops
  Coverage. Retrieved April 4, 2009, from website
  http//www.courier-journal.com/cjextra/healthinsur
  ance/stories/cecil.html
• (slide 2)
• Gingrey, Murphy form GOP Doctors Caucus. (2009,
  March 13). Retrieved April 16, 2009 from
  website http//gingrey.house.gov/News/DocumentPri
  nt.aspx?DocumentID114470
• (slide 12)
• Growing Support For Universal Health Care. (2008,
  March 19). Retrieved February 7, 2009, from
  http//www.insurancespecialists.com/?industry-arti
  cles/?universal-health-care/