Regenerative Medicine and Universal Health Care
While much of the discussion surrounding stem cell research has focused on the ethical use of human-derived tissues, Dr. John Gardner points out that people have also begun to talk about who has access to stem cell therapies. Healthcare is expensive and often inaccessible as a result. According to Dr. Gardner, an egalitarian theorist would say, "No persons should receive social benefits on the basis of undeserved advantageous properties...and that no person shall be denied social benefits on the basis of undeserved disadvantageous properties." This viewpoint argues that people should have equal access to healthcare, with no one denied for unfair advantages or disadvantages. This viewpoint also suggests that healthcare institutions should disperse resources so that people can request additional assistance if needed. Advocates of universal healthcare often find the egalitarian theory appealing.
While many people agree that assistance should be provided to those in need, even if they cannot pay for it, opposers of the egalitarian viewpoint would argue that it is impossible to allocate resources in this way. Libertarians, for instance, counter that a "free market" system of exchanges would be more effective, with a focus on protecting liberty and the individual rights of citizens. Libertarians often do not support taxing citizens to ensure everyone has equal access to medical treatment, such as stem cell therapy, but often support “voluntary and privately purchased insurance.”4
Dr. Lesley Jacobs, a philosophy professor at Florida State University, asks, “Can an Egalitarian justify universal access to health care?" when questioning the practicality of universal healthcare. She describes the "comprehensive" strategy of an Egalitarian, in which everyone has access to an equal share of resources and has some minimal standard of care. When talking about the "minimalist" strategy, Dr. Jacobs explains people must have equal access to resources to have equal opportunities.
She counters the beliefs of Ronald Dworkin, who says that our government should care equally about each of us and that it should try to better our lives. Dr. Jacobs explains that people are inherently unequal as when given the same resources, people will use them differently. She draws attention to human differences, with some people having physical or mental handicaps while others do not, some having diseases that others do not, and some having talents or skills that others do not.
When discussing the "minimalist" strategy, John Rawls asserts that people cannot have equal access to opportunities as they are from different backgrounds and lives (or starting points) and do not have the same talents and abilities. Thomas Pogge adds to the conversation, asking if people are only guaranteed equal access to health care if they have similar levels of ill health. He further poses that people should have full access to treatments for socially produced medical conditions, but not those that are natural. Dr. Jacobs argues that for any of these arguments to be complete, they must explain how we could guarantee universal healthcare with cash equivalents and why humans are deserving of such rights.
What is appealing and unappealing about the egalitarian and libertarian beliefs regarding the allocation of medical treatments?
What do you think about the "comprehensive" and "minimalist" strategies that Dr. Jacobs discusses in her research?
Do you think it is realistic to assume that our government should protect each of us equally?
What do you think about Rawl's assertion that people cannot have equal access to opportunities until they are at the same "starting points?"
Do we have a greater moral responsibility to treat poor health that is socially produced rather than naturally produced? What about diseases that are inherited but worsened by one's environment? Can you think of other examples in which socially and naturally-produced diseases are hard to distinguish?
