Justice and Health Inequalities
I was recently home for a holiday, visiting family and some friends. I had lunch with a woman I hadn't seen since high school graduation. No, I'm not telling you how many years that has been.
We chatted about many things while catching up, but she was very interested in my perceptions of the NHS versus what was available in the USA. She described how she and her husband had to give up on a small business because the insurance premiums became unsustainable. She told me that she funded her own pregnancy because the insurance plan they were on didn't cover uncomplicated pregnancies. She agreed that with the burden of health care costs on employers and small business, it was difficult to find an incentive to take such a risk. The idea of basic health care for all seemed really appealing to her once I described what the NHS was really all about.
Later that evening, I was in a pub in Mystic, CT, and a gentleman sat at the bar next to me. He had just undergone bilateral knee replacements a week ago. His "PT nurse" (his words) came daily to his home and would be coming for another week. He was very happy with his health care. He did not appear to be of Medicare age, but I found it interesting that any third-party payer would still be providing home care to someone able to go to the pub for a pint.
These two people have had remarkably different experiences with the health care system. One got treatment far more tailored than the other. This doesn't happen in the UK. In my work in public health, we strive to reduce health inequalities and provide environments in which all people can be healthy. The British see justice as something beyond a legal meaning. They see it as fairness among all people. To them, their system is just and ours is actually unjust. What do you think? When our very Constitution promises "justice for all," does our health care system deliver?