For and Against Equal Access to Health Care

  • Amy Gutmann
Part of the The Hastings Center Series in Ethics book series (HCSE)


There is a fairly widespread consensus among empirical analysts that access to health care in this country has become more equal in the last quarter century. Agreement tends to end here, and debate ensues as to whether this trend will or should persist. But before debating these questions, we ought to have a clear idea of what equal access to health care means. Since we cannot define equality of access to health care in a morally neutral way, we must choose a definition that is morally loaded with a set of values.1 The definition offered here is by no means the only one possible. It has, however, the advantage not only of clarity but also of embedding within it strong and commonly accepted liberal egalitarian values. The debate is better focused upon arguments for and against a strong principle of equal access than on disputes over definitions, which tend to hide fundamental value disagreements instead of making them explicit.


Health Care Equal Access Health Care Good National Health Care System Impartial Spectator 
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  1. Daniels, N. “Equity of Access to Health Care: Some Conceptual and Ethical Issues.” Paper presented to The President’s Commission for the Study of Ethical Issues in Medicine and Biomedical and Behavioral Research, Washington, D.C., 1981.Google Scholar
  2. Daniels, N. “Health-Care Needs and Distributive Justice.” Philosophy and Public Affairs, X (1981); 146–79.Google Scholar
  3. Dworkin, Gerald. “Responsibility and Health Risks.” Paper presented to the Institute of Society, Ethics and the Life Sciences, Hastings-on-Hudson, New York, 1979.Google Scholar
  4. Fried, C. “Equality and Rights in Medical Care.” Hastings Center Report, VI (1976);30–32.Google Scholar
  5. Fried, C. “Difficulties in the Economic Analysis of Rights.” Markets and Morals. Edited by G. Dworkin, G. Bermant, and P. G. Brown. Washington, D.C.: Hemisphere Publishing, 1977; pp. 175–95.Google Scholar
  6. Fried, C. Right and Wrong. Cambridge, Mass.: Harvard University Press, 1978.Google Scholar
  7. Fried, C. “Health Care, Cost Containment, Liberty.” Paper presented to the Institute of Society, Ethics and the Life Sciences, Hastings-on-Hudson, New York, 1979.Google Scholar
  8. Friedman, M. Capitalism and Freedom. Chicago: University of Chicago Press, 1962.Google Scholar
  9. Gutmann, A. Liberal Equality. New York: Cambridge University Press, 1980.Google Scholar
  10. Nozick, R. Anarchy, State and Utopia. New York: Basic Books, 1974.Google Scholar
  11. Rawls, J. A Theory of Justice. Cambridge, Mass.: Harvard University Press, 1971.Google Scholar
  12. Sade, Robert N. “Medical Care as a Right: A Refutation.” New England Journal of Medicine, CCLXXXV (1971), 1288–92.Google Scholar
  13. Somers, Anne R. Health Care in Transition: Directions for the Future. Chicago: Hospital Research and Educational Trust, 1971.Google Scholar
  14. Starr, P. “A National Health Program: Organizing Diversity.” The Hastings Center Report, V (1975); 11–13.CrossRefGoogle Scholar
  15. Thompson, Dennis F. “Paternalism in Medicine, Law and Public Policy.” Ethics Teaching in Higher Education. Edited by D. Callahan and S. Bok. New York: Plenum Press, 1980.Google Scholar
  16. Veatch, Robert M. “What Is a Just’ Health Care Delivery?” Ethics and Health Policy. Edited by R. M. Veatch and Roy Branson. Cambridge, Mass.: Ballinger, 1976, pp. 127–53.Google Scholar

Copyright information

© The Hastings Center 1983

Authors and Affiliations

  • Amy Gutmann
    • 1
  1. 1.Department of PoliticsPrinceton UniversityNew JerseyUSA

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