I affirm the resolution: United States ought to guarantee Universal Healthcare to its citizens




НазваI affirm the resolution: United States ought to guarantee Universal Healthcare to its citizens
Дата канвертавання28.12.2012
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I affirm the resolution: United States ought to guarantee Universal Healthcare to its citizens.



For clarity I offer the following definition:


Ought: used to express obligation (Merriam-Webster’s dictionary)

Obligation: something you have to do. It is arbitrary to argue whether or not it’s “put to the test”

Universal Health Care (N):

LEE K. BROWN, et al. 09.

“Approaches to Achieve Universal Health Care in the United States” AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE VOL 180 2009

Universal access to health care (sometimes shortened to universal health care): One of the better definitions has been crafted by the American Medical Women’s Association and states ‘‘Access to health care should not be linked to a person’s employment, place of residence, sex, age, marital status, or health status. Health care should be available to all persons on the basis of medical need rather than financial ability or employer contracts’’

My Value is: Justice defined as fairness answering to the demands of both freedom and equality (Stanford Encyclopedia). Justice is necessary to this resolution because without justice, citizens would not be subject to the state and it would therefore be irrelevant if the U.S. had to make decisions for the citizens at all.

My Value Criterion is: The Veil of Ignorance. The veil of ignorance is a system of ethics created by philosopher John Rawls. According to the Stanford Encyclopedia of Philosophy, defines the Veil of Ignorance as Justice as fairness. He created what’s called the “original position”, a system which deprives you of previous knowledge in order to view justice in its fairest way. Essentially, if everyone didn’t know who they could potentially be, people would agree to give everyone certain rights, in this situation the right to health care in order to guarantee their safety and security. They wouldn’t take the chance of being in bad situation and depriving themselves of that right.



Contention 1: The Original Position is the Best Way to Attain Justice


Lyons writes:1 Actors deliberate correct principles behind a veil of ignorance where rights are distributed where we do not know our social status, gender, race, and other characteristics. This creates an unbiased agreement.

Other important conditions laid down by Rawls are designed not only to simplify the choice problem but also to guarantee the moral quality of the outcome. For example, Rawls imposes certain constraints "associated with the concept of right." (130ff) and restricts the alternative principles for consideration by the parties to "recognizably ethical" conceptions (125). Also, the Parties are assumed to have whatever general information is relevant to their deliberations, such as the principles of (true) social theory; but they are deprived of specific information about their society, their own status in it, their specific interests, and their natural endowments - Rawls calls this a "veil of ignorance" (136ff). Given this knowledge and lack of knowledge, each party must reason from the same premises; so, if any one forms a preference, universal agreement on the point is presumably guaranteed (140). Also, moral principles are supposed to be "general," and the veil of ignorance helps to meet this constraint by prevent[s] the contractors from rigging principles to serve their special interests (131). They are, as it were, forced to decide impartially (190). After the parties have chosen principles to govern in ideal cir- cumstances, they are to lay down guidelines for less happy condi- tions-when, for example, institutions do not satisfy the shared conception of justice, or different conceptions compete for accept- ance in society, or some persons pose a serious threat to the security of others (chap. iv). Rawls informally extends his argument to cover such cases. The results are highly complex, and it can be said that they express a bias toward liberty (152). But it would appear that Rawls's general conception of justice is most generally supposed to apply.

The idea of the original position is to place yourself in a situation in which you don’t know basic factors like sex, race, socio-economic status etc. Only then can we determine a universal definition of Justice. Rawls realizes people are selfish and would always want to make sure they don’t put themselves in a situation that would hurt them. For this topic we would put ourselves in the original position and everyone would imperatively agree that they would want equality, or universal healthcare, guaranteed to them. That way if they were put in a position where they were the ones that needed health care and they didn’t have the capabilities of attaining it, they would be guaranteed it in Rawls’s world.


Contention 2: The Liberty Principle Is Just because it Ensures Everyone the Right to Health Care

The liberty principle is set by Rawls to make sure no one is excluded from these equal rights. No one can be excluded because of factors like race, sex, age, etc. that way people would be free to pursue their own personal goals. Using the original position, the liberty principle would be upheld because no one would want to prevent themselves from pursuing their own goals.


Sub point A: Institutional Racism is a Big Part of The Status Quo; It Must Be Eliminated


Vernellia Randall, professor at University of Dayton School of Law, 1998, updated 4/25/2012, “Institutional Racism in the US Health Care System”, http://academic.udayton.edu/race/06hrights/wcar2001/WCAR02.htm, 722/2012 The present health crisis for racial minorities in the United States is part of a long continuum dating back over 400 years. After hundreds of years of active discrimination, efforts were made to admit minorities into the "mainstream" health system but these efforts were flawed. Since 1975 minority health status has steadily eroded and there has been no significant improvements in the removal of barriers that are due to institutional racism. Health Status and Institutional Racism. Minorities are sicker than White Americans; they have more illness and are dying at a significantly higher rate. Because of institutional racism, minorities have less education and fewer educational opportunities. Minorities are disproportionately homeless and have significantly poorer housing options. Racial residential segregation contributes to the concentration of poverty in minority communities. Communities with a high proportion of minorities are more likely than predominantly white communities to be exposed to environmental toxins, including lead and asbestos. Minorities disproportionately work in jobs with higher physical and psycho-social health risks (i.e., migrant farm workers, fast food workers, garment industry workers). Minority communities are frequently the targets of institutions promoting unhealthy products, such as alcohol and tobacco. Thus, the current health status disparity of minorities is the cumulative result of both past and current racism throughout the American culture.

Manifestation of Institutional Racism in US Health Care. Institutional racism in health care has significantly affected not only access to health care, but also the quality of health care received. Institutional racial discrimination in health care delivery, financing, and research continues to exist. In 1999, the U.S. Commission on Civil Rights reported to the President and the Congress that: "[The Government’s] failure to recognize and eliminate [racial] differences in health care delivery, financing, and research presents a discriminatory barrier that creates and perpetuates differences in health status." Racial discrimination in health care manifests itself in many different ways including: _Barriers to Hospitals and Health Care Institutions. The institutional racism that exists in hospitals and health care institutions manifests itself in a number of ways, including the disproportionate closure of hospitals that primarily serve the minority community. _Barriers to Nursing Homes. Minorities are disproportionately excluded from nursing homes because of Medicaid policies which result in fewer expenditures on minority populations for nursing home care. _Barriers to Physicians and Other Providers. Minority physicians are significantly more likely to practice in minority communities. Yet, minorities are seriously under-represented in health care professions and the minuscule efforts to solve that problem (affirmative action) is under serious political and legal attack.

_Lack of Economic Access to Health Care. A disproportionate number of racial minorities have no insurance, are unemployed, are employed in jobs that do not provide health care insurance, disqualify for government assistance programs, or fail to participate because of administrative barriers. _Racial Disparities in Medical Treatment. There is overwhelming evidence of racial and ethnic disparities across a wide range of in clinical care in the U.S. Studies document that the most favored patient is "White, male between the ages of 25 and 44".

_Disparate Impact of the Intersection of Race and Gender. The unique experiences of minority women have been largely ignored by the health care system. Race discrimination and sex discrimination intersect to magnify the difficulties minority women face in gaining equal access to quality health care. _Lack of data and standardized collection methods. The existing data collection does not allow for regular collection of race data on provider and institutional behavior. The lack of a uniform data collection method makes obtaining an accurate and specific description of race discrimination in the health care system extremely difficult. _Lack of Language and Culturally Competent Care. The failure to use bilingual, professionally and culturally competent, and ethnically matched staff in patient/client contact positions has resulted in lack of access, miscommunication and mistreatment for minorities with limited proficiency in English. _Rationing Through Managed Care. The health care financing system has been steadily moving to managed care as a means of rationing health care. There is inadequate oversight to assure that managed care develops more expensive but culturally appropriate treatment modalities, to assure that they do not refuse or minimize the expenditures necessary to develop adequate infrastructure for minority communities, or to assure that the rationing does not result in disproportionately affecting minorities.

Institutional Racism and the Law. Racial inequality in health care persists in the United States because the laws prohibiting racial discrimination are inadequate for addressing issues of institutional racial discrimination. The US legal system has been particularly reluctant to address issues of racial discrimination that result from policies and practices that have a disparate racial impact. In fact, the federal law explicitly allows for such discrimination as long as the institution can demonstrate "business necessity". In addition, the legal system requires individuals to be aware that the provider or institution has discriminated against them and that they have been injured by the provider, two conditions that are highly unlikely in racial discrimination in health care. Finally, the health care system, through managed care, has actually built in incentives which may encourage discrimination. Unlike housing, education, lending and employment, the federal government has not taken any action to address these unique civil rights enforcement problems in health care. State and federal law has proven ineffective in reducing and eliminating racial discrimination in health care and the US government has taken little action to correct the problem. In 1999, the U.S. Commission on Civil Rights reported that "[the government’s] failure to address . . . deeper, systemic problems is part of a larger deficiency . . . . a seeming inability to assert its authority within the health care system." _Summary. Medicine has found cures and controls for many afflictions, improving the health of all Americans. However, health institutions have failed to extend the same magnitude of improvement in health among White Americans to minority Americans. Health institutions have failed to eliminate the racially disparate distribution of health care. In fact, health institutions perpetuate distinctions among racial groups. In the case of health care discrimination, domestic laws do not address the current barriers faced by minorities; the executive branch, the legislatures and the courts are singularly reluctant to hold health care institutions and providers responsible for institutional racism. Thus, the United States has failed to meet its obligation under the Convention on the Elimination of All Forms of Racial Discrimination.

Racism Impact: Rawls shows that the liberty principle must be applied to achieve justice because it is currently the status quo for healthcare to blatantly discriminate against minorities.


Contention 3: A Welfare State Ensures Even the Worst-Off People Have a Manageable Life



Rawls welfare state is different than that of the current welfare state. Rawls believes in the welfare of each individual as opposed to the current utilitarian welfare state. The current system sacrifices some people rights to benefit others. Rawls argues, regardless of how much it helps others, it is unjust to leave out the individual. There must be a certain standard where everyone has a minimum standard of rights and opportunities to allow them to succed. In this is case it is the right to health care. Rawls would affirm that everyone deserves this because they deserve to be healthy so that they may pursue their own goals as stated in the liberty principle. According to Rawls welfare state, healthcare is the MINIMUM people should receive, so they may have their health.


Since it is unfair and impossible to make the objective claim “people deserve what they have,” Rawls principle of the Veil of Ignorance appeals to the people who don’t have access to health for reasons that possibly aren’t their fault. People always get things they don’t deserve. That’s impossible to avoid. However, is it unjust to make sure people get things they DO deserve, such as Universal health care? No! Rawls best upholds the resolution because he provides a position where people could agree on a universal definition of justice, assures everyone the right to attain healthcare, and provides a bottom-line minimum that the worst-off people would have (in healthcare) to allow them to succeed and live full lives. Thus, I affirm.


Overpopulation Block: Overpopulation is a not a problem that will destroy the world

Fred Pearce, author (described by The Times as one of Britain’s finest Science Writers), 2010, The Overpopulation Myth, http://www.prospectmagazine.co.uk/magazine/the-overpopulation-myth/,7/21/2012

There is no exponential growth. In fact, population growth is slowing. For more than three decades now, the average number of babies being born to women in most of the world has been in decline. Globally, women today have half as many babies as their mothers did, mostly out of choice. They are doing it for their own good, the good of their families, and, if it helps the planet too, then so much the better. Here are the numbers. Forty years ago, the average woman had between five and six kids. Now she has 2.6. This is getting close to the replacement level which, allowing for girls who don’t make it to adulthood, is around 2.3. As I show in my new book, Peoplequake, half the world already has a fertility rate below the long-term replacement level. rich or poor, socialist or capitalist, Muslim or Catholic, secular or devout, with or without tough government birth control policies in place, most countries tell the same tale of a reproductive revolution.

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