Distributive Justice Across The Generations

Introduction

Issues pertaining to healthcare have always elicited intense controversy. This is especially with regard to the sustainability of the current healthcare insurance programs for the elderly; Medicare. Indeed, there have been disagreements on whether Medicare should be rationed so as to enhance its sustainability both in the long-term and the short-term. Various arguments have been advanced both for and against rationing healthcare insurance.

The key utilitarian argument for the rationing of healthcare for the elderly rests on the importance of doing things for the greater good (Aaron & Schwartz, 2005). Rationing healthcare for the elderly would ensure that more resources are channeled to the bulging, resourceful number of youths rather than the unproductive elderly people (Aaron & Schwartz, 2005).

In addition, rationing healthcare has been touted as the only way in which health for all can be afforded in the future. While about 70% of workers have health insurance as an employment fringe benefit, this may not be sustainable especially considering the sustained increase in healthcare expenditure by 2.5% every year since the $2 trillion mark in 2004 (Aaron & Schwartz, 2005). In essence, it would only be imperative to limit the availability of any care whose production costs are beyond their worth to patients.

However, healthcare rationing comes as disadvantageous in that it is based on the assumption that decisions on individual medical treatment can be ethically based on determinations pertaining to political will and social consensus rather than private determinations between the physician and patient. On the same note, scholars have underlined the fact people have obligations and rights not just entitlements (Etzioni, 2012). The elderly made their contribution to the society while the youth are yet to take their turn, in which case rationing would be unfair and morally wrong to the elderly (Etzioni, 2012).

While both sides present valid arguments, it is more reasonable to ration healthcare spending especially on the elderly. The rising costs must be weighed against the consequences or rather the benefits of increasing expenditure on healthcare in the long-term.

References

Etzioni, A (2012). Rationing by Any Other Name. Policy Review, No. 173

Aaron, H. J., & Schwartz, W. B. (2005). Can we say no?: The challenge of rationing health care. Washington, D.C: Brookings Institution Press.