Philosophy

Historical accounts on the formation of the state point to the provision of security as one reason that made men to create governments. By giving up some of their rights, the state took responsibility of providing those services individuals could not achieve on their own. As the society grew and expanded, so did its needs. To meet the emerging challenges in the provision of services, governments were allowed to use state apparatus to collect tax from the people to fund service projects. Provision of healthcare is one of the responsibilities bestowed on the government. By paying taxes, citizens are owed health services by their government. Regardless, the current state of affairs point to a startling reality. Theoretically, health provision is widely regarded as a social amenity and as such, a basic human need and right.

 However, the failure by the state to provide adequate Medicare to its citizens has led to the commercialization of health services, making it a privilege of the rich few who can afford. Today, it is a common practice- too common that it seems normal- for healthcare providers to target those who are employed, and billing them directly from their wages. Health policy providers ignore the poor, and the taxes paid to the government do little to improve their plight. At old age, social security membership-also available only to those in employment- is needed for one to access medical services. By examining the healthcare insurance policy for the elderly in the US, the paper argues that there are inequalities in the provision of health services.

The conditions spelled out by healthcare policy underwriters for eligibility of coverage disadvantage marginalized groups in the society. Insurance providers require one to have been in pensionable employment to qualify for the hospital insurance  (Part A). In case one does not qualify on this criterion, then they consider their spouses employment.  The age limit as well as the discrimination along employment records shut out a lot of the lower class masses who have never worked before. Similarly, the age limit means that individuals live their lives waiting to qualify for healthcare coverage. At the same time, the benefits are dependent on the premiums that one was paying, and most of them are way above the means of lower classes. The table below by the Social Security Online reflects this harsh reality for the poor.

Social Security taxes 2009 2010
Employeeemployer (each)
6.2 on earnings up to 106,800
6.2 on earnings up to 106,800
Self-employed Can be offset by income tax provisions
 HYPERLINK httpssa.govpubs10003.html l offset 12.4 on earnings up to 106,800
 HYPERLINK httpssa.govpubs10003.html l offset 12.4 on earnings up to 106,800
Employeeemployer (each)
1.45 on all earnings
1.45 on all earnings
Self-employed Can be offset by income tax provisions
 HYPERLINK httpssa.govpubs10003.html l offset2 2.9 on all earnings
 HYPERLINK httpssa.govpubs10003.html l offset2 2.9 on all earnings

Source Social Security Online

This is reflected in the benefit scheme, which pays retirees in relation to their premiums. This shows that those with higher premiums get adequate coverage than those whose salaries do not afford them high premiums. Source Social Security Online 2009.

On the other hand, healthcare is meant to improve the quality of living at all stages of life. In his book, On Liberty, John Stuart Mill argues that individuals have a right to happiness. The same is outlined in the Declaration of Independence, which guarantees all citizens a right to seek happiness. One way of ensuring happiness, is to be free from hunger, insecurity and disease. By being choosy in the provision of health services among citizens, healthcare providers are dolling out the right to happiness in doses, giving the full rights to the highest bidders. When the provision of health services became commercialized, it gave a leeway for the marginalized groups to be sidelined by profit seeking service providers. Similarly, when private individuals were allowed to invest in healthcare, it meant that only those with the money were going to get the best deal.

Since the Enlightenment Era of the 18th century, emphasis has shifted from societal needs to the individual. Eighteenth Century philosophers emphasized the need for governments to serve the interests of the people. The first notions of human rights are traced to this period, when Chastellux asserted that any government that did not pursue the happiness of its people existed only by imposture and force (McMahon 2006, 217). If people must pay for such basic social amenities such as medical care, then the government has lost its moral authority to rule upon them. As John Locke said
He that will not give just occasion to think that all government in the world is the product only of force and violence, and that men live together by no other rules but that of beasts, where the strongest carries it...must of necessity find another rise of government, another original of political power (Locke, 1947).

It is the responsibility of established governments to apply scientific knowledge to avoid human suffering and pain when children died in infancy, when disease and epidemic haunted survivors, and when many lived as slaves (Harvey 1989). In The Republic, Plato outlined the elements of an ideal state, what he called the just City-State. Plato argued that a just society respected the rights of all citizens. He framed within the wider societal spectrum by emphasizing that the nature of justice for the individual is something that is most easily understood through the understanding of justice in terms of society (Lototo, 2002). Therefore, the selective manner in which healthcare is provided in the American society violates the fundamental rights of her citizens. If one must live until he is sixty five years to benefit from hospital insurance, then that is sixty five years of denied justice, happiness and the right to enjoy life to its fullest. Stuart Mill writes that human actions should serve the interests of the wider society, and that they should be aimed towards a common good. For whose interests does the hospital insurance policy work Apparently, it is not for all Americans, but for those who are capable and willing to pay.

In conclusion, the hospital insurance for the elderly is a discriminatory practice in the provision of health services. Healthcare is a basic human need, which governments should provide without partiality and selectivity. By letting private players into the field, the government demonstrates its failure in providing adequate healthcare to the citizens. Nonetheless, the solution is not to abolish the private sector, but to ensure that individuals are able to access affordable healthcare throughout their lives, despite their economic status. Only then, when healthcare is available both to the poor and the rich, the employed and the unemployed, the young and the old, will there be a government of that works for the interests of the people.