Controversies over the reform of the health care system in the U.S. revolve around the issue of whether medical care is a right or privilege.

The traditional fee-for-service system of medicine assumes that medical care is a privilege, something that we can purchase, such as food, housing, and clothes. Those who advocate some type of government founded health care systems, such as those found in other countries, assume that medical care is right, the benefit that all people should be entitled to receive no matter how rich or poor they happen to be.

At present, the U.S. health care system embodies both of these viewpoints. The Medicare and Medicaid systems ensure health care for the elderly and the very poor, thus suggesting that it is right for those who are in need of it most. Most employers provide health insurance for their employees, indicating that these employers believe that health care is important for their workers-well beings.

Yet, there are millions of Americans for who health care is a privilege. Some work for companies that provide no health insurance; others may be unemployed and ineligible for Medicaid programs. Those who are self-employed often have trouble finding affordable insurance.

As noted earlier in this chapter, reformers and politicians in the United States have advocated changes in the health care system of much of this century, but these efforts have been strongly opposed by powerful corporate actors in the health care system. In the early part of the century, the America Medical Association spearheaded the opposition.

Beginning in the 1940s, the AMA was joined by private insurance companies. Both insurance companies and the AMA are very powerful lobby groups. They contribute huge sums of money to political campaigns and maintain very active lobbying organizations in the nation's capital. Those who have the most to gain from health care system reforms, such as the uninsured, have neither the money nor the resources to begin to match the efforts of these powerful political players.

Source from: Discovering Sociology (Stockard 2000)

© 2004 by Afro Staff