The purpose of this article is to frame the rational discussion of universal healthcare and equal access as it relates to the moral principle of justice. Although the definitions of justice are many, for purposes of this discussion we will recognize the American Psychological Association’s (APA) official definition of justice as cited in the APA ethical code. The complexity of the issue, compounded by the intensity of the debate, will inevitably raise more questions than answers. The rationale is that by employing a decision-making model to the ethical dilemma of universal healthcare, we can guide the discussion in a productive manner by attempting ask educated questions.
The APA is unambiguous regarding equal access to psychological services. The affirmation positions equal access as a mandatory requirement, not an aspirational goal. Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists. (American Psychological Association [APA], 2003, p. 3) We could extrapolate that statement as an admission of support for the underlying principles of universal healthcare. The class text echoes this very sentiment with the declaration that Everyone, regardless of age, sex, race, ethnicity, disability, socio-economic status, cultural background, religion, or sexual orientation, is entitled to equal access to mental health services. (Corey, Schneider-Corey, & Callanan, 2007, p. 21)
Equal access is a challenging proposition in a nation that cannot come to consensus on universal healthcare. The political right would have us believe that’s not what the medical community or the patient population want. The dwindling number of doctors who accept Medicare patients resent politicians and government bureaucrats threatening their fees and meddling with their judgment. This has aided the rapid expansion of private “concierge” medicine for seniors who can afford it and for physicians who demand more than what Medicare offers. (Gingrich, 2009, p. 7)
Meanwhile, the frontlines of U.S. healthcare providers are clamoring for a single-payer universal healthcare system. The California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) co-president Geri Jenkins said any measures short of extending Medicare to provide universal coverage would fail, adding “That’s the majority of the nation’s nurses and doctors – the very people who have the most daily interaction with our healthcare system and see its failures and tragedies up front, favor a single-payer approach, or expanding Medicare to all.” (“Nurses call”, 2009, p. 3)
American Psychological Association. (2003). Ethical principles of psychologists and code of conduct. Retrieved March 18, 2010, from http://www.apa.org/ethics/code/index.aspx
Corey, G., Schneider-Corey, M., & Callanan, P. (2007). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Brooks/Cole.
Gingrich, N. (2009, Feb). The Market Can Fix the Problem. U.S. News & World Report, 146(1). Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=36883618&site=ehost-live
Nurses call for universal healthcare in US. (2009, Apr). Australian Nursing Journal, 16(9), 2/5. Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=37215736&site=ehost-live