Right to health care: What is an encumbrance?
In the post on health care in prisons, MileHiMama asked, "[D]oes ... the government [have] to provide healthcare, or simply ensure unencumbered access to it?"
What constitutes an encumbrance to health care? EMTALA removes the encumbrance of pre-qualification based on ability to pay, but only in emergencies. Most doctors' practices are not affected by EMTALA because they do not provide emergency care.
Medicaid covers people below a certain income bracket. Medicaid recipients have access to routine and preventative care, but people above this income bracket have no guarantee of receiving such care, unless they have health insurance.
Some of these uninsured cannot afford to pay cash for routine care. I see three options for those people: borrow the money, poach from another part of the budget (such as food or transportation), or go without routine care. Do these people have unencumbered access to non-emergency care?
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May 20, 2008 at 12:44 PM
The real question is not access, it is what is basic healthcare? Is it purely lifesaving measures that one has a right to, or preventative/routine care for optimum quality of life? Can one lose their right to healthcare by not following dr.'s orders, or refusing to mitigate the damage of a disease (a diabetic who won't change their diet, for example)?
May 21, 2008 at 12:04 PM
I'm going to grab onto your diet comment. How do you determine whether a person has changed their diet? How much change is "enough"? When I was diabetic (gestational), I still ate occasional treats, yet my doctor and I think I managed my diet quite well. Who monitors it? There are no food police, after all.
I will go out on a limb, too, to say that in my opinion, "basic health care" would have to include preventative and routine care, such as annual physicals and recommended screenings, care for chronic conditions such as diabetes, urgent care for specific problems such as serious but not life-threatening injuries and acute illnesses, and emergency care for threats to life and limb. I would further add prenatal care to the definition of "basic health care."
I think I will explore this question more in the next post in this series.
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