Health Care in the United States: A Right or a Privilege | Health Care Reform | JAMA | The JAMA Network

Health Care in the United States: A Right or a Privilege | Health Care Reform | JAMA | The JAMA Network
JAMA
January 3, 2017
Editorial
Health Care in the United States: A Right or a Privilege
By Howard Bauchner, MD, Editor in Chief, JAMA

The United States is about to embark on a great challenge: how to modify the current system of providing health care coverage for its citizens. However, the fundamental underlying question remains unanswered and was rarely mentioned during the past 8 years—Is health care coverage a basic right or a privilege (regardless of how that coverage is provided or who provides it)? Until that question is debated and answered, it may not be possible to reach consensus on the ultimate goal of further health care reform. Without agreeing to the goal, measuring success will be nearly impossible.

The months and years ahead are filled with uncertainty regarding how the US health care system will evolve.

The ACA needs to be modified, even though it has accomplished a great deal, principally by expanding the number of newly insured individuals. However, much remains to be accomplished, including how to ensure high-quality, affordable health insurance for all residents and how to control the continual increases in annual health care spending, now exceeding $3 trillion.

Sorting out the most effective way to provide health care coverage in the United States is a work in progress and will require careful assessment and likely repeated changes. If the goals of further health care reform are clear and are measured but are not reached, then it will be necessary to return to previous discussions that have included a public option, a single-payer system, lowering the eligibility for Medicare, or further privatization of the health care system.

I hope that all physicians, including those who are members of Congress, other health care professionals, and professional societies would speak with a single voice and say that health care is a basic right for every person, and not a privilege to be available and affordable only for a majority. The solution for how to achieve health care coverage for all may be uniquely American, but it is an exceedingly important and worthy goal, emblematic of a fair and just society.

JAMA is granting free access to the full editorial at this link:
http://jamanetwork.com/journals/jama/fullarticle/2595503