The Declaration of Independence enumerated the inalienable rights of man to be life, liberty and the pursuit of happiness.One might argue that the right to life means there is a right to health care. Unfortunately, for a multitude of people in the United States, the loss of health insurance would be nothing short of a death sentence. Think of the insulin-dependent diabetic or the kidney dialysis patient as examples. And then there are the almost 50 million Americans without health care (a number that has increased along with the huge increase in the number of employed), who are now in a precarious situation. They often do not seek care until small problems become big. For example, prenatal care is rare. Often, they cannot afford primary prevention (prevent a disease from developing) or secondary prevention (preventing an asymptomatic disease from progressing).
While Americans with health insurance may not be taking advantage of preventive services, the person with no insurance is less likely to have the funds for this care. For example, the Robert Wood Johnson Foundation reports that 65 percent of insured female workers have had a pap smear within the last year, while only 44.5 percent of the uninsured have had their check-up.1
In the Bible, God tells Cain that he is his "brother's keeper." Some have translated this to mean, among other things, that we ought to provide health care to all. Along this line of thought, there is an international movement called Responsibility to Protect (R2P). The principles of this movement are twofold:2
- Inherent in the concept of sovereignty is a state's responsibility to protect its populations.
- If a population is suffering serious harm and the state in question is unwilling or unable to halt or avert it, the responsibility to protect those people lies in the international community.
R2P calls for military action when, for example, genocide or a country's unwillingness to protect the health of its citizens is present, as in Zimbabwe.3 I doubt the international community would acknowledge that the lack of universal health care in the U.S. has risen to this magnitude. Nevertheless, the lack of universal health care does cause serious harm to the un- and underinsured. It seems there is a R2P for those who do not have health insurance that does not authorize military action, but political action.
Universal health care is not a foreign concept to most Western democracies. Except for the U.S., universal health care is a right of all citizens in most modern industrialized nations. These countries all look at the U.S. as an anomaly; we will feed the world and provide doctors in Third-World nations, but will not do the same at home. We seem to discount universal health care as a byproduct of the failed socialistic experiment the U.S.S.R. once was.
For the politically liberal, these arguments are more than adequate to support the belief that there is an ethical duty to ensure that all citizens have some minimum level of health care. I have heard various arguments against universal health care, the most extreme coming from the Social Darwinists. They believe life is a struggle and those who cannot succeed ought not let the "failures" weigh them down. One-third of Americans actually believe the rich owe the poor nothing.4 For these extremists, there is still an argument to be made for universal health care - benevolent self-interest. That is, the cost of the uninsured is too great for the insured to bear and the insured would be better off if everyone had health insurance.
Prior to the current economic crisis, one-half of all personal bankruptcies were caused by health care costs. The cost of bankruptcies is borne by all members of our economy. Various studies have looked at the economic impact of the uninsured. They have found that the uninsured are a drain on our economy, which one can only imagine will get worse during this recession.
It is apparent that President Obama believes every American should have health care. As health care providers, chiropractors have an ethical duty to be concerned about the health of those who are not insured and must defend the right of health care.
- Robert Wood Johnson Foundation. www.rwjf.org/files/research/coveragechartpack2009.pdf
- Responsibility to Protect (R2P). http://r2pcoalition.org/content/view/73/93/
- Benjamin. "Tragedy of Zimbabwe." The Washington Times, Feb. 12, 2009.
- deWaal F. "Give Them the Social Darwin Award." TheHuffingtonPost.com, posted Oct. 6, 2007.
Click here for previous articles by Stephen M. Perle, DC, MS.