Personal Responsibility for Health as a Rationing Criterion by Byux - Article Example

Commentary In this article, Byux (871) has identified and explained three major perspectives on which healthcare system can be based, including the libertarian perspective, the communitarian theories of justice, and the luck-egalitarian perspective. After discussing these perspectives on how a healthcare system should be, Byux (872) has identified the possible problems associated with these perspectives and has finally suggested a fourth perspective. Byux (872) calls this fourth theory “liberal egalitarianism” and considers it to find its place “between the rather “radical” accounts of libertarianism and communitarianism” (Byux 872). Byux (872) suggests that liberal egalitarianism is free of the identified problems and if implemented, would ensure the establishment of the best healthcare system. The theory of liberal egalitarianism supposedly establishes a middle ground and also avoids the problems faced by luck egalitarianism. Liberal egalitarianism draws a balance between individuals’ needs and preferences, and their necessity to protect the equality of opportunity without destabilizing a few important societal institutions. Byux (872) has outlined a principle of solidarity to supplement the theory of liberal egalitarianism in an attempt to formulate an attractive theoretical framework which also emphasizes upon the need to consider personal responsibility. The focus of attention on the subject of who is entitled to what kind of healthcare is on personal responsibility. In a free society, people are free to execute any kind of behavior with respect to their health as long as the behavior does not offend the established rules and laws in the society. This suggests that people essentially play a very important role in their own health status. Quite understandably, people who are more conscious about their health and deter from engaging in activities that make them vulnerable to health complications and diseases are likely to face lesser health complications as compared to people who are less careful. In today’s economy, when healthcare resources are getting increasingly scarce and the cost of healthcare is increasing, there is dire need for people to take precautionary measures on individual and collective level. This is important in order to minimize the burden on the healthcare industry as well as on the concerned authorities and government that are responsible for providing people with healthcare resources. The statement of Byux (872) that large population of people will be left with minimal or no health care in a libertarian society is exaggeration. While libertarian perspective is not the best perspective to base the health care system on, it does advocate the provision of basic healthcare to all people beyond which, personal responsibility of people is the decisive factor with respect to who is entitled to what kind of healthcare. Even if a universal healthcare system is established, the discrimination of healthcare provision between the rich and the poor cannot be altogether eradicated. The rich have all the means to buy out the best healthcare, even if they have to relocate somewhere to achieve that. The definition of “basic healthcare” is subjective. This subjectivity originates in the variety of perceptions that different people have about what constitutes basic healthcare. For example, health conditions like foot warts that are otherwise benign and cause neither pain nor discomfort are a matter of concern for many rich people. For the poor, benign foot warts are too less of a problem to seek medical care for. Similarly, conditions like gynecomastia hinder the process of healthy psychosocial development of boys, and often need to be treated surgically. A survey found that “Patients with gynecomastia had lower scores on a standard quality of life assessment, indicating problems in several areas. Even after adjustment for weight and body mass index (BMI), the patients had lower scores for general health, social functioning and mental health” (“Gynecomastic has Psychological” 1). While the treatment of gynecomastia may be extremely important for the psychological and social well-being of a male, an outsider who has never experienced gynecomastia and does not take it very seriously may think of this surgery as a waste of money. The communitarian healthcare system focuses on common good but on the expense of the access of the very rich people or the patients of rare diseases to demand costly or high-class healthcare. Byux (872) rightly points out that the luck egalitarianism overemphasizes the focus on freedom of choice while deciding who is entitled to the healthcare and who is not. There do exist other factors that determine the health status of an individual in addition to genetic factors and personally chosen harmful behaviors. For example, consuming some eatables might be the cultural or religious requirements in a particular community, but their identification as a cause of some health complication on the part of the healthcare professionals would establish this as an objectionable or irresponsible behavior with respect to health. Accordingly, the community would be denied access to the required healthcare. This does not comply with the principles of bioethics according to which, the values of patients ought to be respected in the decisions related to healthcare (Sullivan 1595). A healthcare system based on luck egalitarianism cannot be practically implemented effectively not only because of the subjectivity that exists in the definition of risky health behaviors, but also because of lack of certainty in the identification of all factors that play a role in determining an individual’s health status. Although the liberal egalitarian model of healthcare proposed by Byux (872) does address the weaknesses identified in the three perspectives on healthcare discussed in the paper, yet even this model is not completely free of those weaknesses. Besides, some new weaknesses can be pointed out in the suggested model. For example, while the liberal egalitarian model of healthcare emphasizes common good, it still cannot downplay the importance of being personally responsible toward health. Moreover, the idea of mutual care by both recipients and givers seems very appealing, though it is impracticable on many levels. First of all, not all people are as conscious about contributing to the sustenance of such a system as the system expects or wants them to be. Most people, even those who are rich, are not interested in paying their due share to contribute for common good whereas expectation of any contribution from the economically suppressed class is out of question. Secondly, implementation of such a healthcare system requires some radical modifications in policymaking and fundamental changes in the attitudes and behavior of the society at large, which is time-consuming as well as difficult to achieve. Byux (873) also believes and has mentioned in the article that this liberal egalitarian model of healthcare is complex and a lot needs to be done both in terms of research and in terms of policy making in order to make this idea implementable. The model suggested by Byux (872) does address the weaknesses in the major perspectives on healthcare, but to implement such a model, a lot of critical thinking needs to be done on different levels and in different contexts to work out the optimal balance between people’s needs, their personal responsibility toward health, their affordability, and their desires. Overall, this article is a very good and informative article that has touched upon some radical issues and dilemmas in the contemporary healthcare industry. Byux (871) has identified three very important perspectives on healthcare system design and the model suggested by Byux (872) does address the weaknesses of those perspectives. The article is well-written, well-structured, and contains reliable references to support the facts and statements. The article offers useful insights not only to the healthcare professionals but also to the law-enforcing agencies, healthcare departments, and governments at large whose decisions and policies play a pivotal role in determining people’s access to healthcare resources. Works Cited: Byux, Alena M. “Personal responsibility for health as a rationing criterion: why we dont like it and why maybe we should.” Journal of Medical Ethics. 34.12 (2008): 871-874. “Gynecomastia Has Psychological Impact on Adolescent Boys, Reports Plastic and Reconstructive Surgery.” American Society of Plastic Surgeons. 2 April 2013. Web. 14 Feb. 2014. . Sullivan, M. “The new subjective medicine: taking the patients point of view on health care and health.” Social Science & Medicine. 56.7 (2003): 1595-1604. Read More