American Health Care: Realities, Rights, and Reforms

This book provides a moral evaluation of American health care. It is in three main parts: a review and analysis of conditions bearing on access to quality health care, a philosophical analysis and defence of the concept of a moral right to health care, and a discussion of various policy alternatives for reform of the US system for delivering health care. The first chapter demonstrates that many Americans, especially among blacks, persons from low income families, and those with less education, are underserved by the present system. Persons in these groups have significantly worse health characteristics than other Americans. Do these persons have a right to health care? If so, to what kinds of care and how much? In part two, four contemporary theories of justice and of peoples' rights - utilitarianism, egalitarianism, libertarianism, and contractarianism - are examined and their implications for a right to health care described. Each theory is then discussed in terms of a right to health care that encompasses non-interference with one's health, primary care, curative care under some circumstances, and the freedom to buy additional health care not guaranteed by right. What is to be done? This is the central question of the third part, which examines and evaluates alternative directions for reform of the American health care system.