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Healthcare isn’t just about doctors, hospitals, and nurses but it’s the well-being and bettering of a

person. Healthcare is all about assisting anyone in any way possible to meet their medical needs

for self-development. Healthcare is something that should be offered to people upon their will

because of bodily autonomy because everyone has rights. There are some factors to

consider like cost when it comes to healthcare but, everyone should have a right to treatment. In

this essay, I will examine the American healthcare system from the perspective of Norman

Daniels' Rawlsian theory of justice and demonstrate how, in this regard, the system lacks justice.

The United States health care system is composed of private and public as well as for-profit and

nonprofit insurers and suppliers. In 2019, 28.9 million people under the age of 65 years lacked

health insurance due to high costs, lack of coverage, and ineligibility (Vaugh, 2023).

The US federal government provides Medicare funding programs for those 65 years and older,

low-income people, some people with disabilities, and veterans. They also have a Medicaid

program and a Children’s Health Insurance Program to assist in any aspect they can., and local

coverage and the safety net are managed and funded in part by states. However, the United States

of America does not provide universal health insurance coverage. Several parts of the health

insurance system are the same across the United States, even though there are many forms of

coverage and states frequently have their regulations. Private and public entities own hospitals,

clinics, and other healthcare facilities that are typically not affiliated with health insurance

providers, who work with a variety of healthcare providers (2023). To guarantee that they will

have coverage when they need to visit a doctor, clinic, or hospital, they pay monthly health

insurance costs to provide the best healthcare for themselves. Insurance companies can bargain

with medical providers for lower costs and subsequently cover the cost of treatments. The

Medicare and Medicaid programs function similarly.

Insurance providers usually establish partnerships with a network of doctors to negotiate terms

(2023). Patients are covered for appointments with doctors but may receive partial or no

coverage for visits to doctors outside of the partnership. Insurance companies typically cover

services deemed medically necessary by doctors; however, procedures considered optional are

often not included in the insurance policy. Insurance companies strive to reduce costs while

providing needed healthcare (2023).

The United States estimated that ninety-two percent of the population had coverage in

2018 but eight point five of the population was left uninsured. In 2018 approximately fifty-five

percent of the population was covered under employer’s insurance and because of

this Medicaid and Medicare were enacted ( Roosa Tikkanen et al., 2020). However,

before the age of 65, these employers pay taxes to get healthcare from the government after

retirement. As of today, Medicaid covers 17.9 percent of Americans ( Roosa Tikkanen et al.,

2020) The uninsured rate, 8.5 percent of the population, is down from 16 percent in 2010, the

year that the landmark Affordable Care Act became law ( Roosa Tikkanen et al., 2020) This act

came into law because many people were left uninsured, couldn’t afford the preferred insurance,

or were rejected treatment because of their condition and in 2019, 28.9 million people under the

age of 65 years old lacked health insurance because of these reasons (the book). U.S. healthcare

spending grew 4.1 percent in 2022, reaching $4.5 trillion or $13,493 per person ( Roosa

Tikkanen et al., 2020)

Norman Daniels wrote an essay questioning the argument if there is a right to healthcare and

who dies it pertains to. Daniels argues for a right to healthcare because he reasons that disease

and disability are a setback to people's full potential for golden opportunities in life (Vaugh,
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2023). If people can get treated to help them experience every opportunity life has to offer

to them then let it be is what Daniels is informing. Rawls's theories of justice say that everyone

has a right to equal and basic liberties that are compatible with each other meaning freedom of

speech, religion, and rights, etc. (Gorton, 2024). Rawls’s second principle of justice said that

social and economic inequalities must meet two conditions and that fair equality of

opportunity and to be the greatest benefit of the least advantaged members of society which is

the difference principle (Gorton, 2024). Based on justice for healthcare, Daniel’s sees the second

principle as more relevant because he argues that Rawlsian justice favors equal access to

healthcare, as disease and disability limit equality of opportunity. However, the difference

principle may allow for disparity in access to healthcare if it favors the least well-off (Gorton,

2024).

The healthcare system in the United States is unjust. According to Rawls principles of justice as

fairness and his notion of the “veil of ignorance” emphasize the injustice that occurs in

the US healthcare system. This veil of ignorance keeps people from knowing who they are and

can’t identify their circumstances (2023). Healthcare should be for everyone and just not those

who can afford it because not everyone is as fortunate and the issues that they have are not like

they want to happen to them. Rawls would always argue that healthcare should be universal and

not based on money or wealth but in the United States, there are many people left

uninsured struggling financially, and without healthcare (Roosa Tikkanen et al.,

2020). Furthermore, this is where Norman Daniels argues for equal access to healthcare

(Vaughn, 2023). Just because someone doesn’t seem as if they need help more than the other

person doesn’t mean they shouldn’t be treated. Just because the man is rich with insurance and

the woman is poor and uninsured means he should be treated before the woman if her condition
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is much worse. Based on Rawls’s difference principle, healthcare inequalities should benefit the

least advantaged however in the United States it’s all about your wealth, your title, etc. Norman

Daniels would see the US healthcare system as unjust because he wants equality and highlights

the importance of reducing health inequalities (Gorton, 2024). Healthcare shouldn’t put a burden

on people but provide the best treatment to always have that window open for opportunities in

life. The US overcharges for healthcare and that’s unjust to the people.

In this essay, I examined the American healthcare system from the perspective of Norman

Daniels' Rawlsian theory of justice and demonstrated how, in this regard, the system lacks

justice. Healthcare is more about the improvement, treatment, and well-being of a person than

just about the doctors and nurses. Healthcare is aiding everyone in meeting their needs for them

to become healthier than before. Healthcare should be provided to people at their discretion due

to bodily autonomy, as everyone has rights. When it comes to healthcare, there are various

aspects to consider, such as cost, but everyone should have the right to receive treatment.

Daniel’s and Rawlsian Distribution of healthcare is the more just distribution of healthcare.
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References

Gorton, B. (2024). Bioethics: Health car justice pdf. Clarksville, AR: University of the Ozarks

Roosa Tikkanen, Authors, Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton,

G. A. (2020, June 5). United States. Home.

https://www.commonwealthfund.org/international-health-policy-center/countries/united-

states

Understanding the U.S. Health Care System. InterExchange. (2023, December 5).

https://www.interexchange.org/blog/international-participants/understanding-us-healthcare

Vaughn, L. (2023). Bioethics: Principles, issues, and cases. New York, NY: Oxford University

Press, pp. 312-349.

Veil of ignorance. Ethics Unwrapped. (2023, February 17).

https://ethicsunwrapped.utexas.edu/glossary/veil-of-ignorance#:~:text=Philosopher

%20John%20Rawls%20suggests%20that,consider%20how%20societies%20should

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