Distributive Justice across the Generations

Issues pertaining to healthcare have always elicited intense
controversy. This is especially with regard to the sustainability of the
current healthcare insurance programs for the elderly Medicare. Indeed,
there have been disagreements on whether Medicare should be rationed so
as to enhance its sustainability both in the long-term and the
short-term. Various arguments have been advanced both for and against
rationing healthcare insurance.
The key utilitarian argument for the rationing of healthcare for the
elderly rests on the importance of doing things for the greater good
(Aaron & Schwartz, 2005). Rationing healthcare for the elderly would
ensure that more resources are channeled to the bulging, resourceful
number of youths rather than the unproductive elderly people (Aaron &
Schwartz, 2005).
In addition, rationing healthcare has been touted as the only way in
which health for all can be afforded in the future. While about 70% of
workers have health insurance as an employment fringe benefit, this may
not be sustainable especially considering the sustained increase in
healthcare expenditure by 2.5% every year since the $2 trillion mark in
2004 (Aaron & Schwartz, 2005). In essence, it would only be imperative
to limit the availability of any care whose production costs are beyond
their worth to patients.
However, healthcare rationing comes as disadvantageous in that it is
based on the assumption that decisions on individual medical treatment
can be ethically based on determinations pertaining to political will
and social consensus rather than private determinations between the
physician and patient. On the same note, scholars have underlined the
fact people have obligations and rights not just entitlements (Etzioni,
2012). The elderly made their contribution to the society while the
youth are yet to take their turn, in which case rationing would be
unfair and morally wrong to the elderly (Etzioni, 2012).
While both sides present valid arguments, it is more reasonable to
ration healthcare spending especially on the elderly. The rising costs
must be weighed against the consequences or rather the benefits of
increasing expenditure on healthcare in the long-term.
Etzioni, A (2012). Rationing by Any Other Name. Policy Review, No. 173
Aaron, H. J., & Schwartz, W. B. (2005). Can we say no?: The challenge of
rationing health care. Washington, D.C: Brookings Institution Press.

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