Abstract
The seriousness of the ever-increasing scarcity of basic health care in America frequently prompts the following question. Should the government forcefully intervene in the medical health-care delivery system in order to guarantee that all citizens receive basic medical services, or should the government stay out of the health-care delivery system and thereby allow the mechanisms of the free market to distribute health care like any other service under the formula of supply and demand? As things presently stand, the government has intervened via Medicare and Medicaid to provide health services for the poor and the elderly. But the problem is that in inflationary times the government must put a limit on the amount of Medicare and Medicaid dollars thereby leaving a number of people with less basic care or none at all.
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Notes and References
This line of argument is developed by N. Daniels in his “Health Care Needs and Distributive Justice”, Philosophy and Public Affairs 10 (1981), 146–179.
See, for example, Baruch Brody’s recent ‘libertarian’ defense of the basic right to health care in his “Health Care for the Haves and the Have-nots: Toward a Just Basis of Distribution” in Earl Shelp, (ed.), Justice and Health Care (Dordrecht, Holland: D. Reidel Publishing Company, 1981), pp. 151ff.; and Charles Fried’s “Equality and Rights in Medical Care”, in J.G. Perpich (ed.), Implications of Guaranteeing Medical Care Washington, DC: National Academy of Science, Institute of Medicine, 1981, pp. 3–14.
In reply to Kenneth Arrow’s “Uncertainty and the Welfare Economics of Medical Welfare”, American Economic Review 53 (1963), 941–973, Norman Daniels urges in “Health Care Needs and Distributive Justice” (see note 1 above) that health care services should not be marketed at all, even in an ideal market.
See, for example, H. Tristram Englehardt Jr. “Health Care Allocation: Responses to the Unjust, the Unfortunate and the Undesirable,” in Earl Shelp (ed.), Justice and Health Care Dordrecht, Holland: D. Reidel Publishing Corporation, 1981, pp. 121 ff.; and Leon Kass, “Regarding the End of Medicine and the Pursuit of Health”, Public Interest 40 (Summer, 1981), 11–42.
This is because the two basic views about rights reduce to two mutually exclusive views, namely, teleological (under which a right is to be judged in terms of what is in the interest of the greatest good for the greatest number) and deontological (under which a right cannot be set aside in the interest of the greatest good for the greatest number). Some philosophers continue to believe that there is no objective way to adjudicate the difference of opinion between these two basic positions.
See Kim Carney,“Cost Containment and Justice”, in Earl Shelp (ed.), Justice and Health Care (Dordrecht, Holland: D. Reidel Publishing Co., 1981), p. 173. See also Salkever and Bice, “Hospital Certificate of Need Controls”, AEI for Public Policy Research Washington, D.C., 1979.
For example, the Graduate Medical Education National Advisory Committee recently submitted to the Secretary of Health and Human Services a report arguing that there will be an oversupply of 70,000 physicians in America by 1990 and that dramatic action should be taken to limit the number of new physicians. See Anlage (Winter, 1981), 11.
See Jon B. Christianson, “Can Business Stimulate Competition in the Health Care System?,” Business and Society 19(2) and 20(1) (1980), p. 15 ff.
See my “On the Role of Moral Considerations in the Allocation of Exotic Medical Lifesaving Therapy,” in James M. Humber and Robert Almeder (eds.), Biomedical Ethics and the Law (New York: Plenum Publishing Corp., 1978).
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Almeder, R. (1983). Scarcity and Basic Medical Care. In: Humber, J.M., Almeder, R.F. (eds) Biomedical Ethics Reviews · 1983. Biomedical Ethics Reviews. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-439-9_5
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DOI: https://doi.org/10.1007/978-1-59259-439-9_5
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