Medical Care in the United States: Does Everyone Have Equal Access?

The United States has some of the best and most technologically advanced medical care in the world but, like some other necessities of life, like affordable housing and higher education, it’s not equally available to all who need it. It shouldn’t come as a surprise to anyone that in this country medical care is horrendously expensive and there are differing theories as to why this is so. Some medical economists point to powerful pharmaceutical companies, sometimes called Big Pharma, who charge exorbitant rates for some drugs. Why do they do this? Because they can charge whatever they want. Recent tax cuts for corporations have increased their overall profit margin, and there is little evidence that the increased cash flow will be passed on to consumers or to employees. Others claim that the cost of bringing a new drug from the laboratory, through clinical testing, and directly to the consumer incurs costs of over one billion dollars. Social scientists draw our attention to rising levels of education and the increased longevity among the general population as factors that result in a more educated patient population that expects more highly sophisticated medical care for longer periods of time. It should also be noted that because there are more highly trained and specialized people on the medical hierarchy than ever before, such individuals understandably demand higher salaries. In some countries in Western Europe, especially in the Scandinavian countries of Northern Europe, where the tax base is high compared to what it is in the United States, governments provide medical care to everyone. Not so in this country.

The term ‘The American Dream’ is a meme that alleges that through hard work and perseverance anyone can rise above his/ her original circumstances. It would have us believe that everyone has an equal opportunity to succeed and conversely, that those who don’t are lazy, incompetent, or both. But there are flaws in that approach. The way to live The American Dream is to go to a four-year college, do well, get a career position and work hard at the job in order to climb the ladder to power, opportunity, and a high income. Let’s start with education. It’s not a news flash that higher education in the U.S. is expensive, prohibitively so for some. The costs of attending college, which includes tuition, room & board, books & supplies, and numerous other fees, rise every year. While there are loans and scholarships available to some students, they don’t cover the cost of everything and often leave students with mountains of debt. The costs associated with graduate and professional schools are even higher.

One must also look at public education. In some parts of the country the public education system is abysmally poor, which means that many high school graduates are not prepared for either college or for well-paying jobs. Without good math and communications skills, they are not competitive for any but low-paying jobs or those in retail or food establishments, which rarely offer medical benefits. Educational level leads to a career, which leads to a lifestyle and commensurate income. It all starts with education; without that individuals might have difficulty obtaining medical benefits. For those with college degrees, they are more qualified to pursue career positions, which are more likely than not to offer health care benefits, which is considered de rigeur for such jobs. People with careers see health care insurance as a right, and often have the freedom to shop around for jobs with the most comprehensive coverage. People whose educations stopped at high school or who are not considered marketable for whatever reason, often don’t have the luxury of choosing a position based on the benefits that are offered. So to answer my own question, ‘is medical care a right or a privilege,?’ I offer this: it’s a right for some and a privilege for others.