Introduction
Healthcare relates to the maintenance and improvement of both physical and mental health mainly through medical service provision. Traditionally, healthcare was an individual responsibility but towards the end of the 20 th century, the concept of primary healthcare has spread more so in the developed world (Garrafa, 2016) . Primary healthcare refers to an endeavor to provide basic health care to all the members of a certain community. The philosophy behind it is that good community health relies on the health of individual members. Unlike most of the developed world however, primary healthcare has not yet been availed in the USA (Garrafa, 2016) . Whereas America has arguably the best medical care facilities in the world, many citizens continue to lack basic medical facilities due to financial problems. Others prefer to travel to third world countries in search of medical services. It is this cacophony of grand and bad news that forms the essence of access to healthcare in the USA whose particulars form the subject matter of this research paper.
Literature Review
Overview of the American Healthcare System
The United States has the highest economy in the world and is still considered by many as a super power yet it does not guarantee primary healthcare for all its citizens. Further, it has the largest healthcare system in the world in terms of institutions, research, training, technology and equipment (Garrafa, 2016) . Indeed, the life expectancy in the USA is approximately 78 years of age. Further, Americans who attain the age of 74 have a higher chance to live longer than others in other parts of the world. This statistics reflect major achievement in the health sector. Indeed, according to Barr (2016), the US government spends more on healthcare than any other government in the world with over 64% of all medical expenses by Americans being paid for by the government. However, not everyone who need healthcare in the USA gets it and many who do, get it at exponentially low quality. This is because most government funding goes through insurance programs such as Medicare and Medicaid. Private sector employers also contribute to the healthcare of their employees. These are contributory programs which see the government contribution being directly proportional to the contribution of the insurance holders (Chetty et al, 2017).
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A person who is able to contribute more gets a higher contribution from the government with those who are unable to contribute at all, not getting any contribution from government. Other government programs involve special groups such as the veterans and children. The common American however does not have a particular program to guarantee even access to basic healthcare (Vermund et al, 2017). Further, there is a “widening gap in life expectancy between the most affluent and the most deprived U.S. counties from 1980 to 2000” (Shaefer et al, 2016, pp2, para 4). For the almost 50 million poor people in the USA, the powerful healthcare industry in America is a fallacy.
Healthcare Access Capitalism in the USA
The upshot of the foregoing, therefore, is that the financially secure in America get access to the best possible medical facilities. Indeed, wealthy people from across the globe find the USA as a preferred destination to seek medical attention due to the expertise and facilities available. The middle and working classes also get by quite well as they combine their personal resources with those of the government through the medical insurance programs. In the absence of acute and/or chronic medical conditions, the middle and working class mainly get proper access to medical care (Chetty et al, 2017).
However, in the event of chronic or acute conditions, the propensity of running out of funds for treatment is quite high. Indeed, over 60% of all bankruptcies in America cite acute medical expenses as one of the causes (Chetty et al, 2017). Finally, there are the working poor and the underclass who either cannot afford medical insurance or can only afford the exponentially cheap medical insurance. These individuals get by with access only to mediocre healthcare facilities. Indeed, the Centers for Disease Control and Prevention has a classification dubbed “no usual source of healthcare” (Vermund et al, 2017). This refers to individuals who only figure out where to get medical attention as and when they fall sick. Illegal immigrants generally fall within this category. In many instances, they do not get medical attention and die from treatable diseases and may suffer terribly when they face chronic illnesses such as cancer or HIV/AIDS (Chetty et al, 2017).
The Bioethics of Prescription drug prices in the United States
Prescription drugs are medicines that require a medical prescription from authorized personnel in order to purchase. In America, prescription drugs are more expensive than in almost everywhere else in the world. This is mainly because almost the entire American pharmaceutical industry falls within the private sector and engenders extreme capitalism. Government policy on the other hand leans towards non-interference. Yet it is when people need prescription drugs that they have a lower capacity to work and earn at an optimum. The high cost of prescription drugs has therefore being a major bioethical subject (Garrafa, 2016).
Medical Tourism
As indicated above, most members of the middle and working class get proper or passable access to healthcare except when acutely or chronically ill. This is because specialized treatment in the USA, albeit excellent in quality is also exponentially expensive. Indeed, the acute or chronically ill find it more economical to travel to third world countries for treatment than get treated locally. India has become one of the leading destinations for Americans seeking cheaper treatment for serious medical conditions (Dogra & Dogra, 2016) . These include organ transplants and chronic care. As the world’s affluent travel from across the globe to be treated in the USA, Americans are being flown out by their medical schemes or using all their savings to travel out for treatment (Dhiman, 2016). Many of them are never able to return because of the need for continued medication or deaths in the course of treatment.
Further, regulations on treatment, qualification for medical personnel and training differ exponentially with those in America. Many of the practitioners in these countries would not be allowed to practice in American hospitals without further training. However, due to insufficiency of funds, those who seek treatment there have no choice. It is worthy of notice further that the underclass cannot even afford medical tourism and in many instances are left at the mercy of their ailments.
Analysis and Discussion
It is clear from the totality of the literature review above that the American healthcare system is among the best with the world and a majority of Americans have proper access to healthcare. Many Americans are affluent and capable of taking advantage of the available medical prowess in the nation. The middle class and the working class, who make the majority of the American population, have increasingly gotten proper access to healthcare services. This is mainly aided by insurance programs. With contributions from the government and other employers, these individuals happen to enjoy high level medical services both for primary healthcare and specialized treatment (Garrafa, 2016).
During the pendency and subsistence of their medical covers, these individuals will have access to proper healthcare services and live without apprehension. Unfortunately, there is a very large number of poor people in America with numbers ranging in the tens of millions (Shaefer et al, 2016; Barr, 2016). These individuals may not have stable jobs and are therefore unable to participate in the insurance programs contributory or otherwise. When they fall ill, they mostly find themselves on their own. This becomes very unfair more so for children being brought up in poor families as lack of proper healthcare in childhood affects a child even throughout adulthood (Block, 2016; Vermund et al, 2017).
America has a medical system that favors the rich and discriminates against the poor. The amount of money the government spends on research and medical insurance programs is enough to provide primary medical care for each and every American as well as those domiciled in America legally or illegally. The problem, therefore, seems not to be the lack of money but unfair and wrong policy on the part of the government. Research has shown that providing treatment for all members of the community will result in a generally healthier populace (Shaefer et al, 2016). Taking some monies away from the middle and working classes in order to assist the lower classes would assist even the middle class through the creation of a healthier community. With regard to exponentially high cost of treatment, a good example being prescription drugs, the government should intervene. It is very unfortunate that because of profits, people have to die in agony as they cannot afford prescription drugs. Further, as the largest contributor to healthcare costs in America, a lot of taxpayer’s monies end up becoming unfair profits for pharmaceutical industries. This is over and above the savings of the chronically ill poor and is therefore unfair and against the dictates of bioethics (Barr, 2016).
Final Opinion Relating to the Research Thesis
Access to healthcare in America is a cacophony of grand and bad news. The good news is to the superrich Americans, the middle class and some of the working class. This group gets comfortable access to the best healthcare system in the world. Some conditions that are considered lives threatening in many countries are treated easily resulting to high life expectancy. The bad news however, goes to the working classes who develop acute or chronic ailments. This ends up wiping out all their savings and resulting to bankruptcy. Some of them also indulge in the dangerous trend of medical tourism. The worst news however is to the tens of millions of American poor who have no usual access to healthcare. This group lives under continuous apprehension of falling ill. When they eventually fall ill, access to healthcare services is limited and exponentially expensive.
References
Barr, D. A. (2016). Introduction to US Health Policy: the organization, financing, and delivery of health care in America . Washington: JHU Press.
Block, R. W. (2016). All adults once were children. Journal of pediatric surgery , 51 (1), 23-27.
Chetty, R., Stepner, M., Abraham, S., Lin, S., Scuderi, B., Turner, N., ... & Cutler, D. (2016). The association between income and life expectancy in the United States, 2001-2014. Jama , 315(16), 1750-1766.
Dhiman, M. C. (Ed.). (2016). Opportunities and challenges for tourism and hospitality in the Bric nations . United States: Information Science Reference.
Dogra, A. K., & Dogra, P. (2016). The medical tourism industry in the BRIC nations: An Indian Analysis. In Opportunities and Challenges for Tourism and Hospitality in the BRIC Nations (pp. 320-336). doi: 10.4018/978-1-5225-0708-6.ch020
Garrafa, V. (2016). Access to Healthcare. Encyclopedia of Global Bioethics , 21-29
Shaefer, H. L., Wu, P., & Edin, K. (2016). Can poverty in America be compared to conditions in the world’s poorest countries ? Retrieved from http://npc.umich.edu/publications/u/2016-07-npc-working-paper.pdf
Vermund, S. H., El-Sadr, W., del Rio, C., & Wingood, G. M. (2017). Policy and human rights implications of women’s poverty and vulnerability in the USA. In Poverty in the United States (pp. 221-232). New York: Springer International Publishing.
