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Universal Heathcare - A Moral Dilemma

Updated on October 14, 2011

Where Do We Draw the Line?

All this talk of Universal health care in the US has gotten me into some lively discussions. I've found out 2 things,

1) People who believe in Universal Health Care believe it is a right we should provide to everyone and they don't care about the cost in terms of Dollars

2) People who do not believe in Universal Health Care believe that the government controlling anything will turn it into a disaster.

Now those are broad generalizations. Me personally I come down closer to the second than the first but I digress.

The Dilemma

There seems to be something that is overlooked in most of the discussions I've had but it came up last night. I have to credit my brother. He mentioned it precisely, that we are presented with a moral dilemma, on the one hand, we aren't comfortable putting a value on human life. On the other hand, without changes, health care in the US will consume more and more of our income.

That is no more clearly evident by what is going on with Medicare in the US. Without changes it will soon consume the entire federal budget. Now with talk of Universal health care, and the trillions of dollars it will add to our debt, it just magnifies the issue that the only way to control cost is to ration care.

How do you ration care? You tell certain people there is no cost benefit to treating them. Whether it is because you are terminal, elderly or some other reason yet to be determined, this means somewhere someone is sitting down with a pencil and paper to determine what the value of a human life is worth.

Answers in the Declaration of Independence Vs. Constitution?

This sounds like a moral dilemma. In the Declaration of Independence the first inalienable right was the right to life. In the Preamble of the Constitution it clearly talks about promoting the "general welfare" as one of the reasons for establishment of this country. To promote this "general welfare", choices need to be made because as a country we can not pay for everything. (Notice it is not individual welfare!) I"m not a constitutional scholar but this does not seem to solve anything.

Seems we must decide this based on other criteria.

What is the Value of Life?

Deep question. My sense is that for most people it depends on how close it is to themselves. If it is you or someone you love, it is invaluable. If it is someone you never met who lives on the other side of the country well then it doesn't matter so much. That is my perception.

What I believe is quite different. I believe life is sacred. All life. I do not believe I am worthy to judge the value of someone elses life. I find people who do quite scary.

Now I know right now insurance companies decide who gets care and who does not.  The difference is that first you can appeal that decision to the government and they have the power to fix that.  Second, the insurance company has to make a profit.  If their service or reputation gets too bad, they will not make a profit and go out of business.  There is motivation and ways to pressure an insurance company.  Neither of these exist when the government is in charge.

Finally the big scary part of this is the use of what is called Comparative Effectiveness Research methodology. It basically places a monetary value on human life and decides in the abstract if the cost of treatment is to be given. It is one thing if an insurance company uses this type of process, at least you can sue them to overturn it but it is wholly another to try and sue the US government.

The very people who are supposed to benefit from this plan, the ones who can least afford to defend themselves like the elderly, mentally disabled and handicapped are the very ones who will have their care rationed. Make no mistake this plan means 2 things rationed care and higher taxes.

I really don't like what if's but what if someday they decide to factor in genetic predisposition to decide whether a person gets care?  Is it that much of a leap from what they are talking about? After all if you are genetically predisposed to getting cancer young why should we bother to care for you if you don't have the same life expectancy of someone who is not predisposed to cancer?  It is risking the cost of that health care. 

I believe that life is precious and a gift.  We can not play God.  Having the government decide who gets care and who does not and doing so without consequence is in a sense deciding who will live and who will not.  Our fore fathers declared that life was an important enough value to risk everything to protect.  Seems to me we should protect life as well. 


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    • Tom T profile imageAUTHOR

      Tom T 

      11 years ago from Orange County, CA

      Vrajavala, Terrific point. Thanks for adding to the conversation.

    • vrajavala profile image


      11 years ago from Port St. Lucie

      Of course, this is all based on socialized medicine in England, where they have been cutting back on services for the "terminally ill" for some time. Ezekiel Emanue's' "less valued life" is deeply hypocritical.

      We are a Christian nation and one only has to look at the Parable of the Talents to find out about the "redistribution of wealth" fallacy. Christ was happy to find that one had developed their talents and angry to the one who had buried his talents, and, in fact, gave them to the one who had multiplied his talents.

    • Tom T profile imageAUTHOR

      Tom T 

      12 years ago from Orange County, CA

      Moon Daisy,

      Yes the problem is about how to pay for it and there in lies the issue. Fully funded the tax obligation would be outrageous by any standard. The problem is it can not be fully funded, therefore the only way to get some care is to limit or ration services. How do you decide who gets care and who does not? Well the main architect of this plan believes health care should be provide to those who have value to society. Others should have their care rationed.

      He also believes the Hippocratic oath doctors take to treat patients and do no harm is a bad idea and that it should have a social justice component( to it such that those who have the ability to contribute to the nation should have the better health care.

      This is code for why spend 100K on a heart bypass for a 70 year old when we can do knee surgeries to healthy 25 year olds who will work the next 40 years and pay taxes. It is not the basic care people are concerned about it is the expensive surgeries and critical care. (I would love to see someone survey patients who had to access critical care for countries that had universal care vs. countries that do not.)

      There are surveys here that show upwards of 85% of the people are satisfied with their health care. So why 'fix' it. That is the big question...and the debate goes on.

    • Moon Daisy profile image

      Moon Daisy 

      12 years ago from London

      You make some good points. The main problem (and I'm not American so please forgive me for maybe not understanding all the issues..) seems to be how to fund universal healthcare in the US. That is indeed a very big obstacle and I do not claim to understand what a great task that might be..

      But speaking as a citizen of the UK, a country that has had universal healthcare in place for many years, I can vouch that on the whole it works! We don't have to worry about paying costly insurance fees; through our taxes there is free healthcare for all, irrespective of means. The government doesn't make judgements on who lives and who dies (contrary to what some political people are saying) and the quality of service is generally very good.

      Most British people (and citizens of other countries with universal healthcare) consider themselves extremely lucky to have this kind of a system.

    • rsmallory profile image

      Rebecca Sue Mallory 

      12 years ago from Central Texas

      Brazenly honest, I agree with you and am totally against a nationalized healthcare plan. I do feel like changes need to be made to control costs, but the reform bill as it is currently written is not acceptable. Thanks for this hub. You know your on the list now... lol


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