Health Care Right or Privledge Interview Question

[surftheiop]

Im not interviewing yet, but the question about healthcare being a right or a privledge seems to always come up.

Is it ok to say you think its somewhere between?

Ie. I think if a homeless guy and falls and cracks his head open I think he has a right to get it sewed back up in ER, but I dont think an alcoholic has a right to a liver transplant.

So how to answer the question?

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[Compass]

Im not interviewing yet, but the question about healthcare being a right or a privledge seems to always come up.

Is it ok to say you think its somewhere between?

Ie. I think if a homeless guy and falls and cracks his head open I think he has a right to get it sewed back up in ER, but I dont think an alcoholic has a right to a liver transplant.

So how to answer the question?

Yes, it's okay to go somewhere in between. Of course you can't say no to the homeless guy, but where you stand, the alcoholic has or does not have the right to get a liver transplant.

Of course, defining fault is difficult. If a person smoked for 5 years and has been free of smoking for 30 years and gets lung cancer, or a person who has smoked for 5 years and has been free of smoking for 15 years has lung cancer, who would you pick?

We could discuss basic health care as a right. Certainly not a black/white discussion.

 

[Trexate]

Im not interviewing yet, but the question about healthcare being a right or a privledge seems to always come up.

Is it ok to say you think its somewhere between?

Ie. I think if a homeless guy and falls and cracks his head open I think he has a right to get it sewed back up in ER, but I dont think an alcoholic has a right to a liver transplant.

So how to answer the question?

Listen up girls, I want a good clean fight. No hittin' below the belt, no bringin' up death panels, no crying about the need to socialize medicine. Now let's get it on!!

 

[scotsdoc54]

My vote would be to answer honestly and be able to intelligently defend it. If it's somewhere in between, so that. It's better to do that than to defend an opinion that you may not necessarily agree with, IMO. I think if I tried to defend a position I didn't believe in, I would come across as insincere and an interviewer would know it. Hence, I am not defense attorney, haha.

 

[TopSecret]

If health care is a right, what rights do health care professionals have?

 

[greatnt249]

I would say that everyone has a right to adequate basic care; beyond that, there are too many extenuating circumstances to apply the blanket term "right" to healthcare services. No one has a right to abuse the system, though; that much should be obvious.

 

[Bonesaw45]

This came up in one of my interviews, I can imagine it will be even more reasonable of a question to ask now given US events. This is one of those questions, like 'what is your stance on abortion?', that I think many interviewers stay away from because there is really no answer and it can be inflammatory.

If anything I say don't pick a side, show knowledge of both sides of the argument, know one or two points that encompass the basic principles of each argument. Then say something to the effect of "Well I'd imagine my beliefs about this will change as I experience health care more...blah blah blah" and depending on your read of the situation make a self deprecating comment about how many people have tried and failed so you can't promise the interviewer you can come up with a solution...but you'll work on it.

Just play the fence when they are asking these questions they are not looking for fanaticism, they are trying to see how you grasp the issues, if you are aware of the situation. It wouldn't be fair if they expected an answer that aligns with their personal beliefs, the entire medical community is just as split on the issue as the country is regardless of the AMAs opinion.

 

[Compass]

If health care is a right, what rights do health care professionals have?

The right to be overworked because of everyone else's rights

 

[zayka]

I think health care as "right" for basic care: basic vaccines, check-ups, the right to choose to live a healthy lifestyle.

Otherwise, I believe in a tiered system where people get a certain degree of rationed health care depending on what they can afford (cheap plan is highly rationed; regular plan more closely resembles what is in place now).

 

[ILikeDrugs]

I don't believe in rights, just privileges. Let's say no one decided to become a physician, nurse, pharmacist, pharmacologist, etc., how much of a right is health care now? Society is privileged to have individuals who dedicate themselves to such fields. Society is turning into bunch of self-entitled brats. "Rights."

 

[Trexate]

Personally, I don't feel it can be classified as either.

When I think right, I think free stuff you're born with (personal freedoms, etc.). When I think privilege, I think something you have to pay for.

Health care is a lot like food. You'll die a lot faster without it than you will with it. Do people have a right to food? No. They need food to survive, thus I'd deem it a necessity. Just because you need it to survive does not mean you have a right to it. Thankfully, our government has noticed this discrepancy and set up programs that will give us food if we can't afford it. They have also done this with health care. Sadly, I feel the restrictions on the government programs may be a bit too stringent and as a result, some people who need help are being left out.

Better health care than other people have is a privilege. Much like everything in life, if you want something better than other people have, you should have to pay for it. To keep with the food metaphor, if you don't want to have McDonald's anymore, you'll have to pony up the coin to pay for Bocado, the tapas bar in the city.

Interestingly enough, everyone has the RIGHT to seek out medical care. You can go to the ER, regardless of financial status, and still receive medical care. Without insurance, the bill is unmanageable. However, much like an expensive meal you can't afford, there is nothing to really stop you from skimping on the bill.

Much like others have said, it is not a black and white issue. I think the attempt to make it a black and white issue is to give people an insight into your thought process.

 

[texahn]

Maybe it's a mix between right and privilege. Somewhere in the middle there.

 

[lord_jeebus]

My nuanced answer has been that if it were a "right," there would be a lot of poor countries out there violating its citizens rights for economic reasons alone. A right is not an entitlement but a freedom from a potential restriction.

However, most economically successful societies provide some sort of universal coverage just as we and they provide public sanitation, primary education, firemen and police on-call. You don't have a right to any of those things, but their existence is a reflection of that society's regard for the common good.

Calling it a right oversimplifies the issue - the real issues are lack of public understanding of the advantages and disadvantages of various forms of healthcare public policy; and a population that is quick to judge any sort of government action in terms of terms like "The Constitution" and "socialism" (or "rights" for that matter), which are commonly not understood for what they really are but as surrogates for "good" and "evil."

 

[LiveUninhibited]

Basic healthcare is a right, and basic is defined by balancing the individual patients rights/needs with that of the wider society. We can't spend 5 million dollars in order to have a 1% chance of saving somebody, unless that person has personal resources that can pay for it themselves.

However, could we as a society spend 100k to have a reasonable chance of saving a life? Sure.

So... how much should society be willing to spend per QALY?

If health care is a right, what rights do health care professionals have?

If right to counsel is a right, then what rights do lawyers have?

 

[TopSecret]

Basic healthcare is a right, and basic is defined by balancing the individual patients rights/needs with that of the wider society. We can't spend 5 million dollars in order to have a 1% chance of saving somebody, unless that person has personal resources that can pay for it themselves.

However, could we as a society spend 100k to have a reasonable chance of saving a life? Sure.

So... how much should society be willing to spend per QALY?



If right to counsel is a right, then what rights do lawyers have?

The right to counsel is necessary to avoid having your other rights violated by government. Most lawyers also detest being public defenders.

If you do not have health care, nobody is violating your rights.

 

[kia ora]

If right to counsel is a right, then what rights do lawyers have?

this doesn't make any sense. a right does not correspond to a right. a right corresponds to a duty - a criminal defendant has a right to counsel; the defendant's assigned attorney has a duty to put forth a defense on behalf of his client

 

[BlueElmo]

Like others said, I believe basic health care, such as access to primary and preventive care, ability to get vaccinations, etc are a right. Everyone around the world should have access to basic health care regardless of their ability to pay.
Beyond that, I think things become too variable to say that health care is a right. Obviously, IMO, a person who chooses to engage in unhealthy lifestyle such as alcohol abuse, smoking, etc and later on, need expensive treatments and therapies, is just not right. That person voluntarily did these things to his body and is putting a strain on the health care system, which is unfair to everyone else.
But, like I said, access to basic health care should be available to everyone whatever their cultural or economic backgrounds.

 

[amakhosidlo]

My nuanced answer has been that if it were a "right," there would be a lot of poor countries out there violating its citizens rights for economic reasons alone. A right is not an entitlement but a freedom from a potential restriction.

This.

Health care and other social resources such as water and sanitation fall into an odd category of "Positive", or "Secondary" rights, rights which are essentially pre-requisites to classical "negative" rights. (Positive rights dictate a type of entitlement, whereas negative rights entitle the holder to lack of interference, which society is obligated to honor). Governments, then, have an obligation to uphold these secondary "rights" to the best of their abilities as a means of upholding the "primary" civil rights of their citizens. To provide a working example: If a lack of health care or water restricted the activity of citizens, which in turn precluded their civic participation, and an active decision was made not to provide either resource, that action could by extension be seen as an infringement of a negative, or conventional right to civic participation.

This principle is borne out in the constitution of South Africa, which details the responsibility of the government to provide health care, water, etc to citizens. Can the South African government entirely fulfill its obligation? Of course not, it often falls laughably short. Does this mean that the government is perpetually responsible for violating the rights of its citizens? No. By making a good-faith effort to deliver on their obligation through responsible policy decisions (rationing, cost-cutting, etc.) it's able to uphold the rights of its citizens by providing a reasonable level of access to resources.

In short, health care can be thought of as a right, but mainly in the sense of an ancillary nuance of a social contract.

There are certain circumstances, though, in which I think health care can take the form of a conventional (negative) right. If the right to health care can be thought of as an extension of a right to physical integrity, then I think insurance rescission and patient dumping can both be thought of as blatant violations of the right to health care. Each involves a level of active interference that negative rights prohibit.

 

[obgyny]

so wait, what is your definition of "basic" care? what if a boy needs a heart transplant and his family can't afford the expensive surgery & after care? would you consider that basic?

 

[amph119]

My nuanced answer has been that if it were a "right," there would be a lot of poor countries out there violating its citizens rights for economic reasons alone. A right is not an entitlement but a freedom from a potential restriction.

However, most economically successful societies provide some sort of universal coverage just as we and they provide public sanitation, primary education, firemen and police on-call. You don't have a right to any of those things, but their existence is a reflection of that society's regard for the common good.

Calling it a right oversimplifies the issue - the real issues are lack of public understanding of the advantages and disadvantages of various forms of healthcare public policy; and a population that is quick to judge any sort of government action in terms of terms like "The Constitution" and "socialism" (or "rights" for that matter), which are commonly not understood for what they really are but as surrogates for "good" and "evil."

I. Love. You.

 

[greatnt249]

so wait, what is your definition of "basic" care? what if a boy needs a heart transplant and his family can't afford the expensive surgery & after care? would you consider that basic?

You're manipulating the situation by trying to garner emotional appeal for the fact that a terrible thing happened to a child while neglecting the fact that the heart had to come from someone else. Under your proposal, any necessary life-saving treatment modality would fall under the category of basic care.

 

[CoolWhipp]

I used to believe it was a right. I believe there are certain aspects of medicine that would be better if it were provided as if they were rights. I quit my membership to AMSA, and now believe medicine is more of a privilege. It's too bad I have done so much work for them already.

 

[LHKP0603]

hey!
does anyone know of some good books that cover this issue?

I tend to agree with the post above. This sentiment on healthcare probably differs from country to country, depending on how the system is set up.

But, if healthcare is a privilege, I have a difficult time trying to sleep at night knowing that there are severely disadvantaged individuals (not of their own fault) who are desperately in need of any time of healthcare, yet may be denied access to.

This topic drives me crazy sometimes, because each time I think I may be able to stick to one side, I discover many holes in the argument, and go back to fence sitting.

I wish there was a way to just economically deliver effective healthcare to everyone....

 

[BBender716]

John Rawls (may he rest in peas) would have argued that health care is a right because under the veil of ignorance and in the original position, we would want health care delivered to the weakest members of society - after all that is who we may very well be once the veil has been lifted.

Robert Nozick (the arch-nemesis of John Rawls) would have been like, "uh-uh, I don't thank so! You did not just say that mana rains down from heaven, because it don't! What chu be suggestin is the redistribution of wealth, and to do so would require forcing people to give up THEIR property. And that's like bad and stuff because having to do something against your will is slavery. And slavery is inherently wrong!"

John Rawls would then be like. Yo, listen because U bout to get edjukated. Check it. You have to consider the HISTORY of the distribution of wealth. If wealth is distributed in a unequal way because of injustices in the past, then it follows that redistribution is just.

Whoa? What's going on here? are two philosphers having an all out battle regarding justice theory?

Nozick makes a good point regarding the bolded quote. Mana does not rain down from heaven. Or does it. The Sun is almost a limitless source of energy. Could it be harnessed to provide healthcare to everyone in the world without requiring services to be provided for free which is so displeasing to Nozick. Maybe mana does truely rain down from heaven, but we just are blind to it.

THEORYOFJUSTICEVSNOZICK.ORG

Wow. After reading that post and the other very recent posts that you've made, I have to ask...

...what in god's name are you on right now? lol

 

[BBender716]

The post actually sums up John Rawls' and Robert Nozick's philosophical viewpoints (minus the whole ebonics/surfer tone of voice.) The paragraph about the sun is a load of junk however. And the website at the bottom is fictional of course.

After reading so many polarized debates about health care, with little common ground, I find it humorous to hear others waxing philosophical on a soapbox when it has already been done, and quite methodically might I add. Read John Rawls' "A Theory of Justice." Then read Robert Nozick's "Anarchy, State and Utopia." They do not directly address health care, but their notions of right and privilege can be used to directly address the debate above.

I prefer however to just LOL and riff on this whole thing.

lol touché and awesome job.

You should write the CliffsNotes for other confusing texts e.g. Being and Time and Finnegan's Wake! That would be freakin' awesome.

 

[CoolWhipp]

John Rawls would then be like. Yo, listen because U bout to get edjukated.

Man this is deep.

 

[JJMrK]

Be careful with this one. No matter what you think, you gotta remember that the person interviewing you might have a totally opposite view. Personally, I would acknowledge the arguments that could be made for either side and take a stance somewhere in the middle.

 

[obgyny]

You're manipulating the situation by trying to garner emotional appeal for the fact that a terrible thing happened to a child while neglecting the fact that the heart had to come from someone else. Under your proposal, any necessary life-saving treatment modality would fall under the category of basic care.

Okay, forget the boy and the heart transplant. I am just curious as to what exactly you are all defining as "basic" healthcare? Some of you are arguing that everyone has a right to basic healthcare, but everything else is a privilege.

 

[mechtel]

So how much is a QALY worth?

 

[mirrorpair]

Be careful with this one. No matter what you think, you gotta remember that the person interviewing you might have a totally opposite view. Personally, I would acknowledge the arguments that could be made for either side and take a stance somewhere in the middle.

I wholeheartedly agree that you should acknowledge both sides but I'd be wary of taking a stance in the middle to placate everyone. If your stance is truly in the middle, that's fine. If you don't know, I think saying that is fine too (but at least show you given the topic some depth of thought).

I don't see anything wrong with taking a side that the interviewer disagrees with--in fact, doing so might make you look better. It shows you can be passionate and can stand up to people. If the interviewer harps on it, just politely end it with 'I think we have to agree to disagree' or something like that. The interviewer might get pissed and mark you off for the application but, on average, I think you'd get more mileage out of being thoughtful and honest than by taking the middle road because it avoids conflict.

 

[LiveUninhibited]

Okay, forget the boy and the heart transplant. I am just curious as to what exactly you are all defining as "basic" healthcare? Some of you are arguing that everyone has a right to basic healthcare, but everything else is a privilege.

It's not that everything else is a privilege in principle, it's that it is unrealistic to assume that society can bear the burden with zero rationing. If you spend too much on healthcare, other important aspects of society will suffer. On the other hand, health is a great candidate for a positive right because health is the most requisite for enjoying negative rights. Many already recognize basic education as a positive right, and in our society education is necessary to maximize equality of opportunity, much like health.

In organ transplant waiting lists, ethics are more in line with practice. Nearly all of those people have a right to have a life-saving transplant, but it is simply impossible at this time to save them all, so they must be allocated fairly. Organs are rationed based upon a point scale that draws from how long the person has been on the waiting list, how urgently they need it, and how likely the intervention is to be successful (traditionally defined as % alive after 5 years, IIRC, which still can exclude alcoholics for a half-million-dollar liver transplant). Other areas of healthcare in America are often rationed based upon wealth instead. The problem with single-payer systems is that a new ceiling is introduced for everybody: The budget. Hence I'd prefer a mixed system where something can pick up the government's slack, like they have in France.

So how much is a QALY worth?

$100k/QALY? Totally arbitrary, and really it would come down to how much money society is willing to give up in opportunity cost if it involved tax money. Though I'd stop asking people who have never experienced X disability about how much it would lower their quality of life, and instead ask those who actually live with it in order to adjust the QALY given X disability (though that wouldn't be possible for all disabilities).

this doesn't make any sense. a right does not correspond to a right. a right corresponds to a duty - a criminal defendant has a right to counsel; the defendant's assigned attorney has a duty to put forth a defense on behalf of his client

That was precisely my point. See what I was responding to.

 

[Parts Unknown]

Im not interviewing yet, but the question about healthcare being a right or a privledge seems to always come up.

Is it ok to say you think its somewhere between?

Ie. I think if a homeless guy and falls and cracks his head open I think he has a right to get it sewed back up in ER, but I dont think an alcoholic has a right to a liver transplant.

So how to answer the question?

This question, as phrased, represents a false dilemma. I would suggest you read Maggie Mahar's excellent piece on the topic (and the blog she references).

Bottom line: health care is not a right, but it is a moral obligation for a developed nation. FWIW, I personally agree with this assessment.

 

[dw2158]

My nuanced answer has been that if it were a "right," there would be a lot of poor countries out there violating its citizens rights for economic reasons alone. A right is not an entitlement but a freedom from a potential restriction.

However, most economically successful societies provide some sort of universal coverage just as we and they provide public sanitation, primary education, firemen and police on-call. You don't have a right to any of those things, but their existence is a reflection of that society's regard for the common good.

Calling it a right oversimplifies the issue - the real issues are lack of public understanding of the advantages and disadvantages of various forms of healthcare public policy; and a population that is quick to judge any sort of government action in terms of terms like "The Constitution" and "socialism" (or "rights" for that matter), which are commonly not understood for what they really are but as surrogates for "good" and "evil."

great post. thanks.