Health Care: Innovation vs. Access
Critics of the government facilitating heath care often worry that taking some or all of the health care field out of the realm of private enterprise will lower the degree of innovation for which the United States system is known. I’m dubious of this claim, given the role of government grants in promoting innovation and the fact that government organizations such as the military get their hands on cutting edge technology, but for the sake of argument, let me presuppose that government run health care does, on average, lead to the outcome of less innovation. Let me also presuppose that government involvement in health care, whether through supplemental programs such as Medicaid or through a socialist system such as single-payer, results in greater access to health care. These two presuppositions arguably set up the heart of the ethical dilemma pertaining to health care reform in the United States: whether or not to sacrifice some quality of care for the sake of universal access.
To answer this core question, we have to ask ourselves which has a greater ethical value: some people having access to a higher level of innovative care or almost all people having access to a lower level of innovative care. I submit the latter, but I grant that the choice is far from obvious. For one thing, technological innovation, while today exclusive to those who can afford it, tends to include more of the population as time goes by. Today’s extraordinary care may be tomorrow’s ordinary care. If the choice were between some innovation and no innovation, I might be ethically paralyzed, but such is not the choice, even presupposing what I have above. Justice names health care something to which we are all entitled and for which we are all responsible; it does not universally demand first rate innovation. If human life is worthy of respect, then it deserves more than the negative right of not being killed; it merits basic nourishment and care. Consequently, I would say that, as a rule, the path to universal access ethically outranks the road to the best possible innovations. What say you?