During the time that I have worked with the What Sorts Network, I have often asked myself the following:
Is the denial of care to persons with disabilities a necessary feature of universal healthcare or one that is entirely contingent on attitudes towards people with disabilities? If it’s a necessary feature, which system do we pick?
I was too young to be aware of the accusations leveled against Clinton’s healthcare reform, so I was interested and surprised to see that the healthcare debate in the US has turned to these questions. After reading an article this morning (False ‘Death Panel’ Rumor Has Some Familiar Roots) and commenting there, I thought I would bring the discussion back to our blog.
I worry that the denial of care to persons with disabilities is a necessary (and extremely undesirable) feature of universal healthcare, because some type of triage appears to be necessary–people will only be willing to sink a certain amount of money into healthcare and those facing triage will disproportionately be the elderly and people with certain disabilities.
As an American living in Canada, I have seen low-income individuals in the US, more often than not minorities and other socially vulnerable groups, denied even routine care (like the setting of broken bones) because they were unable to pay for it. I have also heard the stories of Annie Farlow, Katya Sansalone, and Kyle MacDonald in Canada. I don’t have enough information to come to any sort of conclusion, so I would be very interested in what our readers think. What are your responses to my questions?
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The idea that vulnerable populations are worse off under a Canadian-style healthcare system (or the most Canadian-styled system–Canada’s!) is common, but I’m not sure there is solid support for that view. Whenever there are comparisons between Canada and the US on healthcare and vulnerable populations, one has to be clear how the 30%+ of the US population without or with very limited health care coverage are being counted. Disproportionate amongst those, of course, of members of vulnerable populations. So whenever a figure is thrown out, ask whether it factors in (e.g., in averages, rates, per capita coverage, etc.) those in that 30%+ population. My guess is that once you push on this, you’ll find that the US as it is is very good on some things for members of vulnerable populations, and very bad on others; ditto for Canada, and more generally for Canadian-styled systems, i.e., the vast majority of health care systems in the rest of the “first world”: UK, Western Europe, Australasia.