Ethical Case Study: Universal Health Care in the US?

Created by J. Marzo

The U.S. is debating whether to adopt a universal health care system, and one of the people watching this debate closely is Maria, a 47-year-old restaurant worker from Florida who has been struggling with high medical bills for years. Maria has diabetes, a condition that requires regular medical care and expensive prescription drugs. Although she works full-time, her employer does not offer health insurance, and she cannot afford the out-of-pocket costs of private insurance. As a result, Maria often skips doctor’s appointments and stretches her medication to make it last longer, risking her health.

Maria’s situation is not unique. In the current U.S. healthcare system, even families with insurance are often financially strained. In 2022, the average annual premium for a family health insurance plan was $22,463, with employees paying around $6,106 of that amount directly through their employer-sponsored plan. This doesn’t include the high deductibles, which average $1,669 per person, meaning families must spend thousands of dollars out of pocket before insurance even kicks in. For those who don’t have access to employer-sponsored health insurance, purchasing coverage independently through the marketplace can cost even more.

On top of these expenses, the cost of prescription drugs is another major burden. In 2020, the average American spent about $1,200 per year on prescription drugs, but for individuals with chronic conditions like Maria, this cost can be much higher. Many families are forced to choose between paying for medications or other essential expenses, such as housing or groceries. This has led to a situation where even middle-class families, despite having health insurance, are struggling with medical bills, and medical debt remains a leading cause of bankruptcy in the U.S.

Proponents of universal health care argue that no one, like Maria, should have to choose between financial ruin and their health. They believe that healthcare is a human right, and a universal system would ensure that everyone, regardless of income, has access to necessary medical care. Countries with universal healthcare, like Canada and the U.K., often have better health outcomes for low-income populations and spend far less per capita on healthcare than the U.S. does. In the U.S., administrative costs in the healthcare system are among the highest in the world, and proponents argue that a single-payer system could lower these costs by eliminating inefficiencies and focusing on patient care.

Opponents of universal healthcare argue that while the intention is noble, it would be prohibitively expensive, and would likely lead to higher taxes for all Americans. They also worry that government-run healthcare systems often experience long wait times and rationing of care. For example, in countries like Canada, patients sometimes wait months for non-emergency procedures, leading to concerns that quality of care would decrease. Opponents also argue that competition in the free market drives innovation and provides better overall care, which could be lost under a universal system.

The real-life struggles of people like Maria—and countless American families struggling with the costs of healthcare—underscore the urgency of this debate. Families are paying more and more for their healthcare, and many are still left with gaps in coverage. This case study explores whether the U.S. should adopt a system that ensures healthcare for everyone, or continue with its current structure, where healthcare is tied largely to employment and ability to pay.

Analysis Questions

1. Is healthcare a fundamental human right, and does the government have an obligation to provide it to all citizens, as in Maria’s case?

2. Would universal healthcare improve overall public health and well-being, or would it lead to a decrease in the quality of care, as critics fear?

3. How should society balance the cost of universal healthcare with the need to provide equitable care for all, given the high costs families are already paying?

4. Should the U.S. look to countries like Canada and the U.K. as models for universal healthcare, or should it develop its own system?

5. Does a universal healthcare system promote virtues such as compassion and fairness, or does it foster dependency on government support?