In America, access to quality health care is currently available only to those who have good health insurance, either because their employers provide it, or because they can afford to purchase it independently. However, the United States faces a serious problem that promises to get worse: the inability of many residents to gain access to needed health care, primarily because of cost.
Patrick and Erickson (1993) state the problem in socioeconomic terms: "Although geographic, cultural, and educational barriers limit access to care, financial barriers dominate. Poor people, near-poor people, and persons with chronic illness--especially those without public or private insurance--find it difficult to obtain health care services (p. 333). The scope of the problem is especially apparent in view of the fact "the United States is the only industrialized country other than South Africa in which the public (government-financed) sector share of health care is less than 60 percent . . . health care is, in fact, a very big business--the nation's third largest industry (Reagan, 1992, p. 14). Instead of offering blanket coverage on the basis of citizenship, "the United States offers access to health services mainly on the basis of age, income, and employment" (Fox, 1993, p. 78).
The bleak setting described above will continue to perpetuate the rationing of health care services, and social service agencies which provide social safety nets for those in need will continue to operate on marginal budgets. A national integrated social-health policy is needed to address the serious problems in our social-health and personal behavior systems--fragmented and limited access to health care, poverty, homelessness, hunger, AIDS, substance abuse, person abuse, and the list goes on. These are social health problems rather than individual health problems, but an ethical, responsible society cannot disregard its social ills any more than it can its ind...