Ethics and access to health care

As the American system of health care delivery strains under the weight of erratic coverage, inefficiency and uncertain quality, proposals for how it should be reformed have proliferated. Some proposals focus primarily on improving quality, others on restraining costs; all, directly or indirectly, address access to health care. We present a consensus framework for evaluating how well a proposal addresses the issue. While access is affected by a number of factors (geography, distribution of providers, and so on), for this essay we focus primarily on ethical issues in access to health care coverage.

Ethical obligations to guide reform of the current system:

1. Every member of society must have an adequat array of core health care benefits.
2. The contents and limits of health care benefits must be established through an ethical process.
3. The health care system must be sustainable.
4. The health care system must ensure that its stakeholders have clear responsibilities for which they are accountable.

In addition to these obligations, the Ethical Force Program also developed a series of recommendations. These are available in the Ethical Force Program's essay, "Improving Access to Health Care: A Consensus Ethical Framework to Guide Proposals for Reform." View the complete essay (PDF, 96KB or online from The Hastings Center Report).
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