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The concept of fair distribution entails equitable distribution of available resources to different members of a community. When expounding on justice in healthcare, it is imperative to distinguish between equity and equality in order to be in a better position to comprehend the fundamental ethical issues that are related to healthcare provision. Equity refers to fairness as well as justice in the distribution of resources. It refers to the approaches that are undertaken in order to avoid biasness in the provision of services. Equity should be put into consideration while addressing health care issues in relative to the society as a whole (Calman & Downie, 2011). For instance, the United Kingdom has well established frame works that ensure that equity prevails in health care facilities. For example, the United Kingdom public health care ensures that all patients are given equal treatments, favoring the worst off, maximizing total benefits as well as promoting and rewarding social usefulness. The United Kingdom healthcare does not consider the ability to pay as the determining factor for the scarce-life saving interventions. Equal treatment of people is important especially in situations where many scarce interventions like organ transplants are indivisible. For such undividable services, provision of equal chances at the scarce intervention is paramount in ensuring equality of opportunities (Emanuel, 2009).
The United Kingdom uses the approach of lottery to ensure that the available scarce resources are allocated fairly. The adoption of the lottery approach to intervene in cases of scarce resources has several benefits. For instance, the approach gives all the concerned individuals equal opportunities to gamble for the few available resources where the lucky person wins despite his/her social background. Similarly, lottery is a quick method for allocating scarce resources as it requires very little knowledge about the patients. Subsequently, the lottery approach is rarely affected by corruption issues. However, the major shortcoming of lottery is found in its inability to determine the most appropriate individual to receive the scarce resource. For instance, it is not regarded very appropriate to allocate a scarce resource/organ to a person who is approximated to live for less than a year even after receiving the scarce resource, whereas the same resource could have been more beneficial to a person who can live for approximately 40 years if given the organ. Most health care facilities in the United States of America adapt the approach of first –come –first –served instead of using lottery in allocation of health care scarce resources. This means that the healthcare scarce resources are allocated with regards to those who come first. Some people regard this approach as more appropriate in ensuring equity. They argue that the use of the concept of first-come-first-served strategy helps to prevent doctors from discontinuing interventions like the respirators even when other criteria dictate so. Nonetheless, this strategy has got some challenges in the allocation of scarce resources as people who are able to push to the frontline stand a better chance of survival, while they may not be the neediest. Moreover, the concept of first –come –first –served, encourages corruption in that, the most influential people or those with the right connections are preferred for scarce interventions. For this reason, the United States of America should abolish this strategy and adopt the United Kingdom concept of lottery in scarce resources intervention in healthcare facilities in order to ensure that they operate in accordance to the principal of fair distribution in health care.
The United Kingdom healthcare approach of ‘favoring the worst off’ involves giving priority to the sickest patients as this gives them some hopes for future. Some people argue that it is imperative to give attention to those people who are most affected first, as patients who are not very sick have a probability of recovering unaided or while being served or through the use of other interventions (Emanuel, 2009)
Equality is another important aspect that is related to health care provision. In health care, equality refers to the comparison between the cost of health care and the ability of individuals or communities to access health care. Health care insurance provisions are very important in helping all citizens to afford appropriate medical services. Approximately all developed nations provided universal healthcare coverage to their residents apart from United States of America that has only a public universal coverage referred to as Medicare for the poorest adults as well as an insurance coverage known as Medicaid for its poorest children. In addition, the United States of America has embraced the United Kingdom approach of ‘favoring the worst off’ where it requires all its hospitals to give the first priority to the sickest people (Emanuel,). The United Kingdom National Health Service provides health care to all United Kingdom residents. The National Health Service is committed to providing equal services to all residents despite their diversity in terms of age, social economic status, geographical, among other factors. The facility offers healthcare services to most UK residents free of charge. In UK, people pay for their health care service in form of taxes. All people in UK receive equal treatment because they make equal contributions as they pay their taxes (Stanhope & Lancaster, 2008).). This is contrary to what happens in health care systems in many other countries such as U.S. The United Kingdom healthcare enables one to receive diagnostic care as well as treatment for any disease free of charge. This includes receiving free pre-natal as well as post-natal care services. The only amount of money that some people are required to pay is a negligible prescription fee. The Healthcare provision in the United States of America is poor. A great fraction of Americans are not entitled to appropriate health care services since they do not possess any health care insurance. The 2006 Census statistics revealed that about 47 million Americans are not entitled to any health insurance coverage. Consequently, the United States of America will need to amend its healthcare system in order to reflect that one of the United Kingdom that guarantees affordable health insurance for all. Although, the uninsured receive health care at public hospitals, the care they receive is often very little and often too late (Daniels, 2011).
The Cuban health care system is another appropriate model the United State can borrow from. The Cuban government has established community-based polyclinic as its centerpiece. These clinics have greatly boosted the country’s health care results. The Cuban government usually provides adequate credits to the countries health care system which has enabled its healthcare system to be similar to that of developed nations. With the help of the polyclinics, the Cuban government has succeeded in the provision of universal healthcare that is of better quality, integrated service as well as well organized (Bulletin of the World Health Organization, 2008).
Statistics reveal that, even though the European nations are as well affected by inequality in the heath systems, it is not as pronounced as in the case of the United States of America. Therefore, the U.S. is in a dire need to ensure equitable distribution of healthcare system. In order to achieve this, it should restructure its healthcare system in order to reflect the one in the United Kingdom or that of Cuba.
Reference List
Bulletin of the World Health Organization. (2008). Cuba’s primary health care revolution: 30 years on. Web.
Calman, K & Downie, R. (2011). Ethical Principles and Ethical Issues in Public Health. Web.
Daniels, N. (2011) Justice and Access to Health Care. Web.
Emanuel, A. (2009). Principal of Allocation of Scarce Medical Intervention. Web.
Stanhope, M., & Lancaster, J. (2008). Public health nursing: Population-centered health care in the community. St. Louis: Mosby Elsevier.
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