APPROACHES OF MEDICAL SOCIAL ECONOMICS AND ETHICS TO IMPROVING HEALTH CARE FOR THE POOR AND LOW-INCOME COMMUNITIES
A significant proportion of the population in the United States cannot afford health care insurance. Most estimates place this proportion of the population at approximately 12 percent (Feldstein, 1998); however, Cockerham (1998) estimates that the proportion of the population without health care insurance at 17.8 percent. Within an estimated total population of 260 million, therefore, more than 46 million have not health care insurance on the basis of Cockerham's (1998) estimate.
The people without health care insurance include the working poor (the indigent), as well as the destitute and the fortunate few whose assets allow them to fund any level of personal or family health care need. A majority of those persons without health care insurance in the United States are able to receive some level of health care through the Medicaid program. The Medicaid program is operated by the states but is regulated and largely funded by the federal government.
Over the past five years, however, the Congress has been quite busy redefining poverty, need, and welfare eligibility. The result has been that millions of indigent persons (the working poor) have lost their access to Medicaid. Others who have ejected from welfare through the imposition of time limits and other criteria have been forced into the ranks of the indigent, further swelling the ranks of those persons without access to health care.
This study examines the approaches of medical social economics and ethics to improving access the adequate levels of health care for the poor and for low-income communities. The contexts of this examination are scientific reasoning, moral authority, and applied ethics in a professional role.
Scientific reasoning involves the use of a set of skills that enable a person to assess factors in a rational way to arrive at a sol...