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Health of nations: government participation in medical care management.

Article Excerpt
Man has almost constant occasion for the help of his brethren, and it



is in vain for him to expect it from their benevolence only. --Wealth of Nations (1) Adam Smith. 1776.

Benjamin Franklin, a virtue ethicist among other things, believed that, "Early to bed and early to rise makes a man healthy, wealthy, and wise."

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His advice is arguable, but few disagree with his list of greater goods--health, wealth and wisdom. Should a government be concerned with citizens' health, or only with their economic security and education?

What ethical principles are available to help us answer that question? Which ethical principles are reflected in existing U.S. health care policy and its implementation?

The three features of an ethical dilemma are:

1. Decisions made and actions taken affect many stakeholders

2. This impact persists over a long time

3. Because stakeholders have conflicting interests, no available and feasible choices are either absolutely right (correct, and virtuous) or absolutely wrong (incorrect, and vicious).

In university classrooms, one ethical dilemma discussed by students is: How much health care should be provided by government, if any, and for whom? Should all citizens get government-funded medical care, or only groups selected to receive this entitlement?

If selective, what should be the basis for including and excluding citizens from health care coverage? Are some mechanisms of funding health care fairer than others? We claim to be a "moral nation." Does existing U.S. health care policy support that claim?

Let's look at the aspect of health care most worrisome to a nation's citizens--the ability...