This started out as a reply to Amy, but got too lengthy for a comment. I also thought a new thread would be better for opening it up for discussion.
Disclaimer: I do not have the answer to this problem, and I find myself vacillating between two ideals. But I am going to put his out there for your consideration.
[regarding "Sicko"]
Yes, michael moore is too dramatic, and slants his work to the nth degree. He also oversimplifies the solutions. Canada works, but he didn't look at the other costs. You lose a good deal of your healthcare autonomy, the gov't makes the tough decisions for you, like if you are going to get the dialysis you need, or that cholycystectomy that would make your life so much more bearable. There is a reason that those who can afford it come from all over the world to get their healthcare here in the US. Is the current system troubled and probably going to implode? Yes.
But is socialized medicine ethical?
I suppose it depends on if you think healthcare is a right or a privilege. Most of us in the trenches of healthcare go with the former, rather than the latter, but this presents a dilemma. the tragedy of the commons is a metaphor that has been applied to biology, economics, evolutionary psychology, sociology, and now healthcare. It goes something like this:
There is a finite amount of pasture. Everyone in the village has equal access to it and allows their cattle to graze.The downside is that the resource is exhaustible. Rationally, it makes sense to each individual herdsman to maximize his gain, that is to add to his herd. He asks what the gain would be to him. The positives of adding to his herd are realized by him only, the negatives of overgrazing the land are shared by all the herdsman and so each experiences just a fraction of it. So the logical thing for each individual to do is to increase his herd. But every herdsman does it. Therein is the tragedy, that each man is locked into a system that compels him to increase his herd without limit, in a world that is limited.
Ruin is the destination toward which all the herdsman push by each pursuing his own best interest in a society that believes in the freedom of the commons. Freedom in a commons brings ruin to all.
So, is everyone entitled to unlimited healthcare? Or is socialized the way to go. Do you subscribe to a utilitarian view or a deontological one?
Moore does his best to piss off the population and fuel the rancor towards the current government. I think he is very effective at that. But you have to take him for what he is, a movie maker. He exposes many of the injustices our current system employs, and that is not at all bad. I just don't like it that he thinks he has all the answers.
Our healthcare system is jacked up, and sooner or later, change will occur. And I doubt it will matter what philosophical stance you have. It scares me nonetheless.
Since my mind is so much simpler :), I have a hard time grasping what the outreaching results would be from either situation. (Your herdsmen analogy was "cute" and good. Tim would be so proud! :) haha) There are so many ripples from each thing that it becomes overwhelming to me to be able to analyze it effectively.
ReplyDeleteThat being said, without thought to ALL the ripples, my first inclination is that I don't want others making healthcare choices for me (as they have other agendas as indicated by the HMO process than actually seeing I get the best healthcare).
Right or privilege? Hmmm.. I think that America's premise is that it's a right. I kind of adopted that premise I guess, but I'm not really sure what I think now.
As much as I would like to take credit for the analogy, I can't. Garret Hardin first posited it, back in the 50's or 60's I think.
ReplyDeleteIt makes you think about a lot of things. Can we each be trusted to look out for the common good at the expense of our own gain? Probably not, so we need enforcers. But then who monitors them?
It can get pretty convoluted.
I think that the scenario you are describing presents several complex ethical dilemmas, one of which may be best addressed by applying the principle of distributive justice.
ReplyDeleteThere are two components to distributive justice as it relates to health care. First, every patient should be provided with the same treatment given to any other patient under similar circumstances. Secondly, access to resources should be distributed with an awareness of the limitations of resources and the population group in need.
The rub exists when there simply is not equal access to these resources.
This becomes evident when you see that individuals from other countries, those with particularly deep pockets, are able to come to the States for the excellent healthcare and receive it because they are not bound by the restrictions of what insurance will or will not cover, a situation which limits the access to available resources by so many Americans who cannot pay cash for the services.
The reality may be that this country has the ability to offer the most sophisticated and advanced medical treatment out there, but these resources are not equally available.
Taken to the nth degree, this puts a monetary value on human wellbeing, even human life, and that seems to me to be a significant ethical hurdle.
Yes, I think you are right. Distributive justice is a good option. Theoretically ;)
ReplyDeleteWe have two options with DJ- We have some type of oversight that manages the healthcare rationing, ensuring that everyone gets a fair shake. Or we all act in the best interest of the community. THe latter would lead us right back to our commons. And with the first option....well, are we certain those with the power to make the decisions are making them in the best interest of the community? Who watches the watchers?
The other thing is, the role that monetary gain plays in the advances of healthcare. As callous as it sounds, and as unfortunate as it is, we have the best healthcare in the world because there is money to be made in it. What happens when that impetus is removed? There is one camp that feels that healthcare is and should remain a capitalistic venture.
Yep, this is very complicated, ethically as well as economically. There are no pat answers. Despite what Michael Moore thinks.