Geographic Accessibility

Even those who have health insurance can face obstacles to receiving care, de- pending on where they live. Both rural areas and poor inner-city neighborhoods in the United States typically have relatively few health care providers per capita. Meanwhile, other areas have an excess of doctors—a situation that can pressure doctors to increase their prices or perform perhaps unnecessary procedures to maintain their incomes despite competition for patients. These problems suggest that for both economic and medical reasons, we should also evaluate health care systems according to whether they include mechanisms for encouraging an equitable distribution of doctors such as providing low-cost loans to medical students who promise to work for a few years in underserved areas.

has inherent worth, they reject the distinction between unfortunate and unfair circumstances. Instead, they argue that each individual has a right to at least a minimum level of health care. Moreover, they argue that all members of a society are interdependent in ways that a rhetoric of individualism fails to recognize. For example, doctors who believe they should have full control over how and to whom they provide services fail to recognize the many ways they have benefited from social generosity. Medical training relies heavily on tax dollars, as do medical research projects, technological developments, hospitals, and other health care facilities. In accepting these benefits of tax support, therefore, doctors implicitly accept an obligation to repay society through the health care they provide.

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Similarly, those who support a right to health care argue that to consider the decision to purchase health care as simply an individual choice misrepresents the nature of this decision because it hardly makes sense to define something as a choice when the alternative is death or disability. Nor does it make sense to talk about the purchase of health care as a choice when individuals can do so only by giving up other essentials such as housing or food.

Finally, those who support a right to health care recognize that society could never afford to provide all available health services to everyone but argue that this should not limit society’s obligation to provide a decent minimum of care to all. Doing any less, they argue, denies the basic worth of all humans.

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