Social justice is a concept of fairness, whose aim it is to expose and bring to end social inequalities. The argument is that all social primary goods should be distributed equally, if there is unequal distribution then it should favor those who are least advantaged.
The utilitarian view supports the principle of the greatest good for the greatest number. Classic utilitarianism was a social reform movement whose goal was to improve the living conditions of the less privileged in the hope of creating a civilized society where both concern for oneself and the common good could occur (Almgren, 2006).
According to utilitarianism, utility is an intrinsic good and actions are judged as right or wrong depending on how much happiness or pleasure they can produce.
In his book, Rawls shifts the utilitarian focus from a concern for good to a concern for right. In affirming that ‘right’ had a great priority than ‘good’, Rawls then asked, ‘what is the most basic civil right?’ the principles of justice that we put across were the liberty principle and social and economic principles.
Examples of basic liberties include political liberty, freedom of thought, liberty of conscience, right to own personal property among others (Almgren, 2006).
The second principle of social and economic equalities states that these equalities should be arranged to ensure that all offices and opportunity. Fair equality does not mean merely that positions should be open on merit; rather that everyone is presented with the opportunity to acquire the skills of the position.
The US healthcare policy presently does not have a prevailing basic for social justice; instead many principles of distributive justice are used: for people over 65 and younger people with certain medical conditions, healthcare is a right of citizenship.
For the young working class American, healthcare is a right of employment, of having private insurance and in some cases both. Middle-class Americans find themselves in a situation where they have to pay for the care of the elderly and also for their own care and that of their children.
In social justice principle justified norms can be established in various ways and these are the principle of distributive justice. Among these are egalitarianism where every person receives equal benefits and burdens, merit-seniority where persons are rewarded according to the length of time they have held a job.
Socialist where people are given burden according to abilities and benefits based on needs. The libertarian’s principle states that benefits are obtained as others give them voluntarily and as the individual creates them for themselves, through labor with material that they own rightfully.
Socialist healthcare would be provided in a social government where being a citizen, entitles the individual to basic coessential services like education, income and healthcare. If the United States had a national coverage in effect it would be socialist healthcare. The current system only has features of this in those over 65 years.
The basic principle in the social justice, theory is impartiality that is that every one’s life is important and equally so. The has been applied to healthcare so that basic treatment includes treating conditions which hinder ones functioning, affect one’s well-being and cause suffering.
Awarding young working classing Americans insurance cover based on distribution principle of merit-effort or merit-output where persons are rewarded according to their work effort and quantity and quality of work.
Evolution of healthcare policy
During the preindustrial times medicine was more domestic than professional, medical practitioners were more of traders, there was no health insurance, private or public.
Medical training was inexistent and most hospital offered services for free, the quality of services was poor so most people hardly went to hospitals. People relied on faith healers, medicines sales people and a few physicians. As the 19th century began most Americans began to view healthcare as a science and physicians became more dominant.
Before World War I government involvement in healthcare was kept at a minimum and was limited to public health and health issues in time of war and treaties. The federal government began to get involved in healthcare for two reasons, one was to meet healthcare policy goals and the other more important at the time was to enable framing and reframing of political philosophy that would outline the roles and boundaries of federal role.
Among the first acts of involvement was the legislation that taxed wages of seamen to aid establishment of the US Marine Hospital Service. Other Acts followed namely the National Quarantine Act, War Risk Insurance Act that availed medical benefits to war veterans and the Vocational Rehabilitation Act and the World War Veteran Act. (Almgren, 2006).
At this time government involvement was aimed more at promoting industry and productivity than at the welfare of workers
The major policy goals after World War II involved investment in healthcare infrastructure by granting hospitals tax exemption, training health professionals with government grants and financing medical research among others. Between 1965 and 1975 healthcare was expanded to increase accessibility by the poor, disabled and elderly through Medicare and Medicaid. This shows inclusion of the concept of social justice.
From 1975 the focus has been on cost containment of healthcare. The inflation of healthcare currently makes it difficult even for the middle class to access healthcare. Then increasing cost of healthcare has been contributed to by advances in medical technology.
This have increased knowledge and led to specialization causing people to live longer and a need for staff training, requirement of new facilities the cost of which have to be shouldered by the consumer. This leads to disparities in the provision of health.
Due to the finite nature of resources in the health sector it has been difficult to apply an egalitarian system in meeting the needs of the public hence as indicated by the
history of US healthcare most of the policies have been for the greater good rather than to meet needs of individual citizens equally. This is likely to be the trend and it should be so.