Healthcare: is it a right or a luxury? | Tarik Sammour | TEDxAdelaide
ฝัง
- เผยแพร่เมื่อ 27 เม.ย. 2024
- Is healthcare a right or a luxury? The answer each individual gives to that question depends largely on their previous experiences with medical care, and on their geographical background and personal philosophy. It is not as simple as it sounds. But the world is getting smaller, and it is imperative that we develop a shared understanding of what kind of healthcare system works best for society in general, and how to fund this effectively. In this talk, Tarik Sammour challenges the audience to think about these questions and engages them in a passionate debate, while putting his own personal spin on things as all good speakers do! Tarik Sammour is a surgeon at the Royal Adelaide Hospital and an Associate Professor at the University of Adelaide, specialising in advanced bowel cancer surgery, patient outcome centred research and robotics. Throughout his training, Tarik has been privileged to work in a wide variety of healthcare systems, from the smallest general hospital in rural New Zealand to one of the largest medical centres in the United States, giving him a unique first-hand insight into what works well for patients and what doesn’t. One of the reasons he eventually chose to settle in Adelaide was because he saw the city’s potential as a leader in healthcare delivery and innovation. With an ageing population and spiralling healthcare costs, he has some ideas to solve problems that are relevant to us all. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at www.ted.com/tedx
This is the first time I've heard a balanced and unbiased analysis of the healthcare industry.
This is the first time I've heard a balanced and unbiased Ted Talk
@@UltraRik (1) This is a TEDx talk, not a TED talk. (2) His discussion sounds balanced but it really is misleading about the actual data.
@@julianjanssen5499 You're free to offer a refutation of any of the claims he made.
@@UltraRik It isn't so much what he said, it is what is left unsaid.
@@julianjanssen5499 You are free to offer a refutation of his general position
It's a necessity that has to be affordable to all. Atleast that's the kind of society I want/wish I lived in.
Healthcare is neither a right nor a luxury. Much like food and shelter, it's simply a necessity. Tarik is spot on that a hybrid model is the best model to pursue. It would be privatized but allow full portability and collective bargaining. The government would play the role of referee: regulating the players thru registration & licensing, punishing bad actors, ensuring standards of quality, and providing tax subsidies or credits for people under a certain income. Like a football game, the government is best as the referee and should never coach or play the game.
I agree that a hybrid method should be employed, but I can't decide how to designate the government's role in the system. It seems to me that allowing the government to regulate, license, and meditate is what the government is already doing, and that seems to produce a never-ending increase of government involvement. My proposal would look something like letting the government apply restrictions to insurance companies and using taxes to ensure that people who cannot afford care for themselves, while lifting as many restrictions as possible to try and stimulate the healthcare market. Ideally it result in the healthcare market growing and becoming competitive, transparent, and cheap enough that lower socioeconomic classes would be able to participate and purchase their own care, while allowing the free market principles to produce the best and cheapest heathcare products possible, just like amazon, apple, and others have changed lives by adding so much value to the average person's life. I think this would take care of lots of ethical issues that could be at stake, including beneficence in allowing markets and competition to do amazing work, and achieving nonmalefacence by not abandoning people who cannot fend for themselves in the current healthcare scene in the US.
I know people hate to hear it, but the ACA was a huge step in the right direction. Unfortunately, without the individual mandate the model is doomed to fail.
Great point
This is a GREAT summary regarding healthcare and a good approach for us to follow.
@J P
Libertarian spotted.
The purpose of government intervention isn't to help an industry to thrive, it's to protect the end consumers and the people from getting screwed by businesses and corporations.
That is why construction businesses is regulated with building codes and building inspectors to make sure that the houses built is safe for the home owners.
Without regulation, nothing prevents a construction company from cutting cost by building using hazardous materials such as asbestos.
We should view healthcare as a public good instead of a business. People that make comparisons with food and healthcare is accurate. However, the prices aren't. Food can be cheap, while healthcare for the middle class is extremely high. Unfortunately.
Because of Medicare and Medicaid, not because of the free market
@@alexanderbeauregard287 No.
@@alexanderbeauregard287 us spend more on private insurance then any country on earth
Healthcare is ridiculously expensive. However the government paying for it and declaring it a right won't solve anything. It won't solve the fact that it is still really expensive. The solution.... let insurance companies compete... the Healthcare industry is the most restricted market in the US. There is a reason why it's the most expensive
Quality of life is much more important than quantity of life. Help us to live as best we can for as long as we can. Each of us has a trajectory that is virtually unchangeable.
As a US citizen on public healthcare after having amazing private healthcare with my parents, this is an extremely interesting and thought-provoking talk. Many interesting things to think about.
US healthcare is a tapeworm on the economy
I truly enjoy listening to this topic, I actually came here to help grab an idea for one of my university presentations. However one thing I wished more addressed was the mention of just general markups in America’s healthcare system. Diabetes is a big leading factor in the US, and while many people can develop it overtime, majority are born with it. Insulin costs about $5 to make, however without paying substantial healthcare prices, a vast number of individuals pay up to $300 a month! While we love to fly our flags and talk about the greatness of our patriotism, our own contenders, our providers are leeching everyone out of their hard earned, minimum wage, salaries. Everything should be used with care and patients should understand the quality they are receiving but just like in the talk, it should be equal, pay out of pocket for top of the line, and for the rest, just let them survive affordably.
Sam - I totally agree with you! I think it's absurd how these big pharmaceutical companies mark up prices when it comes to medications that a patient needs simply just to live. However, it's not necessarily the providers that hike these prices up--it's the manufacturers, the insurance companies that take advantage of people, those that are higher up in the food chain. Providers and physicians merely help patients and cannot do anything about the price of medication.
There's a higher need for justice in healthcare. And unfortunately, that ethical ideal is slowly slipping away from us. Justice says that individuals should be treated fairly and equally, yet it seems like (with the current of how things are) that the rich are the only ones that deserve proper healthcare and treatment plans. I wonder how we could flip the script? I know it's not easy but it's worth the effort to think about. The root of healthcare is non-maleficence ("do no harm"), but sometimes, it feels like we are so far from that. Healthcare is a necessity. It's a right. And, that shouldn't come with a bill that seems impossible to pay.
A truly insightful and thought provoking talk.
Universal Health Care is a hoax! Socialist doctors are a bunch of quacks who know nothing about diagnosis. I knew a woman in my church who had terrible pain. She told the doctor, "I need a biopsy." The doctor insisted she was fine: just aches and pains of aging. It turned out she had cancer and now she's dying. All those huge medical bills for nothing. The pastor is even worse off. Every time he goes to the doctors, they ignore him and make everything worse. Socialized medicine is going to kill even more people than abortion.
Some good ideas. And people here have some great comments. It is especially interesting to
hear the personal health crisis many of you have gone through. And how you have reconciled, or
tried to reconcile, our Healthcare system to your needs.
Myself and Nurses at work talk/debate on this complex issue a lot. Alas, we have no cure for the
Health system dilemma in the US. We know many things it needs...just not how to get there.
And to be honest, I'm sipping red wine and eating fresh baked apple pie with caramel over the
top... So I'll be one of those needing the system, and undeservedly so.
Destroy the American Dream of being equal in healthcare is kind of genocide , is kind of against the healthcare of the American people ? - 110 Universal healthcare Nations on this Earth so far…
really cool opinion thank you.
I worked in healthcare (US), hospitals set their own prices and our outrageously high and can vary, same with doctors, same procedure can cost $4k or $40k and not any better or different, there is no standard. Some other countries with great healthcare also pay education, dr's aren't loan poor (also high Mal/insu,we sue a lot here) dr's feel like they owe society and not the opposite, some countries dr's, teachers, cops all get paid the same, like $150k, not millions. Also their government does the haggling with supplies, pharma and devices keeping costs down, don't have to pay for all the different billing and coding ( highest cost in healthcare)
That is how the government gets you. They work you to death because you feel like you owe them. Having a set salary for doctors means doctors don’t get paid fairly. You may have a good doctor and you may have a bad doctor, both of which get paid the same. If the bad doctor messes up, they probably won’t get fired, they will probably get moved to another location. Have you ever wondered why doctors who work in America are from other countries? It’s because we pay them for their work.
Yea but difference is in my country healthcare is basic human right, it's written in constitution
@@cassandrahagerman4361 What do you smoke?
Dr. Tarik Sammour was very candid in explaining his personal experiences with the healthcare system and how things differ from country to country. This allowed for a more effective open discussion of the issue of whether healthcare is a right of it is a luxury. I would like to state that healthcare is neither a right nor a luxury. It is a necessity of human kind as we see the population is more in need of healthcare for various reasons. With the mass production of food we have seen an increase in GMO products that are causing health issues in many children who grow up to develop other health conditions, this is just one of many examples of why we are more in need of healthcare. We also have a big set of people who are growing older and need more care in comparison to younger population. With all this in mind there are many things to consider about providing free healthcare to all or fully privatizing the field. Lets put it into perspective, a younger and overall healthy person came down with a case of Covid and an older patient with some pre-existing conditions has a case of Covid. In both patients the chief complaint is Covid which makes it seem that free healthcare is the best option to go with. However, we need to consider the patient as a whole and when we think about that the cost of taking care of the older patient goes up a lot more in comparison to the younger patient. This begs the question on how we can equitably and efficiently distribute funds to better serve the community. This is a social justice issue that needs to have a multi-fold solution that allows for a mixed approach with both government aided and private sector healthcare. A mixed approach will also allow to keep the quality and access to healthcare equitable to the major population. This is an important concept that needs to be talked about and have a solution enacted as soon as possible due to the high demand of healthcare rising each year.
Good business in healthcare becomes more like a sick care. Healthcare shouldn’t be looked at as a luxury but as necessity. The responsibly lies with all of us.
@@jacklan4103 because they are easier to pay healthcare isn't
In the US you could end up in thousands of dollars in debt
@@jacklan4103 because unfortunately there have been fewer jobs and a lot of them don't have any money
Compare the price of your average apple to the price of an x-ray which is easier to pay off?
@@jacklan4103 It's a necessity, not a right.
kenway road lowest unemployment rate of my life time rn fewer jobs ????? Where????
Healthcare should be a right but the reality is it’s not
We pay for and because of that we have more treatments available then our UK counterparts
"...but it does require open, frank, discussions, about cultural perceptions..."
Democrat Party has left the chat.
Maybe offer truly competitive prices and stop feeding govt complicity with price-fixing, or as in the USA, criminal monopolies.
Brad Bannister lmao I guess starting a business, taking risk, employing workers and adding value to ur business is a crime now, love socialism
@@baiteatosu lol bootlicker
Andrew567 which company today holds a monopoly? If you mind me asking
That’s what you call free market healthcare
In this discussion, Dr. Sammour starting his talk with the dichotomy of privatized versus universal health care models was a nice foundation for the rest of the presentation. The most insightful point of the presentation, in my opinion, came when he mentioned the second of his three key points: care about cost. I believe that a physician laying out the costs of different surgeries or diagnostic tests, not to mention the treatment plans that follow, could jeopardize their role as a fiduciary for the patient. Of course, there is a price tag for everything in this world, and health care is no exception. However, a doctor’s responsibility should be to provide the best care possible within the means of their health care system to the patient. Factoring in the cost analysis could influence the patient’s decision in their care more than it already does if they are fortunate enough to have insurance to help cover their hospital costs. If discussing the cost of these procedures is factored into the equation, I believe this would be challenging the beneficence a health-care provider is assumed to uphold with their patient. The reason I think this is because it could lead to suboptimal medical decisions to achieve better financial decisions. It is assumed through a physician following the key ethical tenet of beneficence that they are morally obliged to provide this gold standard of care. However, Dr. Sammour did comment further on his point that certain healthcare decisions such as inexpensive wound dressings can provide just as much benefit as the more expensive ones. I do agree with him on this point, because there are certainly opportunities to be less wasteful in a hospital setting and still achieve quality patient care. Finally, the last point made in the discussion emphasized another ethical tenet: the patient’s autonomy. I agree with Dr. Sammour that the patient ultimately has the final say in difficult decisions regarding his or her care. The quote at the end of the discussion includes “reasonable cost” as a goal in cancer treatment, which to me seems to violate the fiduciary role of a physician toward the patient. Ideally, the finances would not be a contributing factor into these tough decisions, but clearly it has a place in medicine that is not leaving
Hi Toppertin92006! I too agree that this talk brings up utterly important topics. The idea of universal health care versus privatized health care. I often wonder what 'rights' truly mean? What does it mean to have the right for clean water? What does it mean to have the right for food and shelter? What does it mean to have the right to have safe abortions? Well, rights are whatever the government decides is a right. Personally, I do not fully trust that our government ALWAYS has our best interest in mind. We have evidence that the government again and again decides things for us that instead of looking for our best interest, it looks for personal capital gain. Anyhow, this deviates a bit from the idea we are talking about. I hope society and government in the United States of America is able to evolve from the current health care system put in place right now, as it is clearly not the best at offering health care to all. I am not saying it is the worst, but we can clearly agree that there is room for improvement. Like Dr. Sammour states, right now the United States of America operates mostly in a privatized health care system where you need to pay exorbitant amounts of money to have an insurance that is often lacking in coverage and still charges a lot of money to have. I have also witnessed what social health care that provides free care for all and that is run by the Mexican government looks like, and it is also not pretty. However, I have seen in Mexico how there is also a huge privatized healthcare industry. Like how Dr. Sammour states, I believe in balance. I always have. I believe that the answer lies somewhere between those two systems, privatized and socialized health care for all. I also believe that we have 50 states in the United States of America, and that the country is so large it allows it to experiment in different states to see what works best. We should encourage change in our states, collect data, analyze it, and compare results considering cultural differences in between each state to see what is most effective and most health for the people. This is what I believe would allow us to grow and become a healthy community and society. It does require experimentation and work however, and also lack of corruption in our government. All very hard things to do. However, the alternative is to do nothing, and I do not like that alternative. Anyhow, I appreciate the points you brought up Toppertin and fully agree with what you have mentioned in your long paragraph
I loved this talk!! Makes you think...
My recommendation would be to build more hospitals and employ more doctors/nurses. The more you build, the more competition there will be. This will drive the prices down without switching from one payer model to another. Making healthcare completely free for everyone will not fix the root cause of the problem. Our country needs more high level development if it wants to keep the high quality care and high productivity.
Sirxchrish Mexico is already giving out free health care.... why not USA too? Why are Americans so against that?
@@yousuck2139 Who cares about Mexico? What I'm trying to say is that Healthcare shouldn't be free because it's not a human right. It's a service that requires a lot of time, training, and money. However, life shouldn't be treated like a game of monopoly and overcharge people in dire need. My suggestion is tougher to achieve but it's more fair and levels the playing field for everyone rather than going from extreme corporatism to extreme socialism. Both are terrible.
@@Sirxchrish I think it’s a human right, this is opinion
Birth shouldn't be free
The US healthcare system as it stands right now could always use more nurses, doctors, or other personnel and it has been like that for years. As easy as it is for us to just say “why don’t you just hire more doctors”, there are several reasons why this is not happening. Which is quite frustrating to many of us who are currently or have recently been down the path of a career in medicine. Out of the thousands of medical students who are accepted into school, after 4 years of gruesome training, there is still about 10% who don’t have a residency spot. While there are other reasons, this simply because they accept more medical students each year than they have spots in residency programs. They have tried to raise the number of residency spots in the last year but its simply not enough and we have to look for a solution elsewhere for now.
I want to bring up the question of this video and that is, is healthcare a luxury or a right? Some may not even be able to answer this question and I am not sure that I can either. I think the ethical principle of justice would be able to answer it fully, and the answer in this case would be it’s a right. All people regardless social status, race, etc. must be treated with a fair and equitable distribution of healthcare resources, but this is not the way it is or else we would have socialized medicine. I agree with you in your comment when you said that making healthcare free for everyone will not fix the problem. However, when I sit back and think about that I think I agree with you for selfish reasons.
Like the doctor spoke about in this video when it comes to doctor practicing in private healthcare “we are like kids in a candy store”. We want the newest and best treatments for our patients to have the best chance. This is where my ethical obligations of beneficence and justice are somewhat at tug of war, because as a doctor I want to treat my patients equally, but also to the best of my ability to create the greatest outcome. A socialized healthcare system would coincide best with justice, while a private one would more with beneficence. I truthfully want to be able to fulfill both of these in my future practices. I like what the physician said in this video about finding a happy medium between this too systems. So perhaps healthcare can neither be a right or a luxury to be successful. The next question is how do we find this happy medium? Communication with patients is key, what do they want from their healthcare system and how can we provide that for them by honoring the ethical principles of justice and beneficence?
As a Nurse I am amazed at this information.
Here in Canada we have ONLY socialized medicine...we pay a good chunk in taxes (42%)
toward healthcare and we are barely handling it now. ie. long waits at hospitals for emergency services, backlog of diagnostic procedures and delays of months to years for elective surgeries. Our baby boomer population is just getting started to get really old. This one tier system will most certainly collapse within the next 10 years. Hybrid is the way to go, ASAP.
My sociology professor here in Texas is Canadian and she was in tears telling me about how her son had an infection that could have easily been treated but he was stuck in a waiting list for months and never got taken care of. His infection became sepsis, he went into shock and he died. This is what free healthcare is good for: making people die from infections that could easily be treated if only they could get in to see a doctor and be prescribed antibiotics. The intent of free healthcare is admirable, but the result of it in practice is that people die just like they would if there was no healthcare at all.
The problem is that there is no perfect way to triage. Triaging based on money (i.e., private system) is for sure not ideal, but what other ways are there to triage. Maybe technological advancements will help us find another solution.
I am canadian and you cannot deny long wait times and deaths due to it. Our system is not perfect, some people (admittedly not many) do have to go to the U.S. for care.
Though, I am not advocating for private healthcare, instead for more public funding.
Joshua Reyes I’ll take things that never happened for 500 please.
@@joshdudeguy2830 It's called rationing that's how they keep the costs under control. When the govt controls 100% of healthcare then you have no voice, freedom or liberty.
I admired Dr. Sammour’s ability to effectively communicate unbiasedly both viewpoints on what still stands to be a very important discussion in healthcare. I believe Dr. Sammour was a great person to speak on this topic as he has had the experience of working as a physician in both socialized and privatized healthcare systems. I believe that healthcare is a right based on the ethical principal of justice. This principal related to medical ethics is a fair and equitable distribution of health resources. However, we are denying people access to healthcare based on their economic standing which violates this principle. However, Dr. Sammour brings up a great point that it isn’t financially possible for a government to be able to provide all of its citizens with access to top healthcare procedures and pharmaceuticals. So the compromise would be access to deficient healthcare instead, which wouldn’t be a solution. Dr. Sammour’s hybrid model does pose a solution but is it feasible to have both a socialized and privatized model of healthcare working simultaneously? I think that if our country provided a socialized healthcare model for basic healthcare such a primary and preventive healthcare and a privatized model for more advanced care and pharmaceuticals, we would be fulfilling our ethical justice principle. By providing all citizens with access to primary care/preventive medicine we can provide education that is vital to preventing so many chronic conditions. By eliminating the amount of people that develop these chronic conditions, less people would need to financially qualify for the more advanced/expensive treatments. I also think Dr. Sammour brought up another great point when he mentioned that we should be discussing improving the quality of a patient’s life and not just the quantity. He also mentioned discussing financial costs with patients. The quote that he put on the screen said “The goals in the treatment of cancer are to prolong survival with an acceptable quality of life, and at a reasonable price”. I think this touches on the ethical principle of truth-telling. The principle of truth-telling embodies a healthcare providers moral responsibility to be honest with their patient about all aspects of their healthcare. This includes procedures, risk, financial costs etc. Employing this principle by providing a patient with clear and concise information about how certain measures will affect the quality of their lives protects a patient’s autonomy.
Sammour’s speech raises an important ethical questions about the role of healthcare in society. From an ethical perspective, healthcare is not just a matter of individual preference or market forces but rather a fundamental aspect of human well-being and dignity. In my opinion, his talk is well balanced and thoroughly thought out in a reasonable way. He discusses how as a society obsessed with treatments and prolonging of life, we have almost dug ourselves into a hole and created treatments that are expensive not only in their own right but also because they are highly sought after.
He lays out a 3 point plan in which the first point he makes is that the healthcare system needs to be a hybrid of both social and private healthcare because both have benefits and pitfalls. In combining these two systems which Australia has tried to implement, we can create a system that becomes both a right and a luxury. The second point he makes is that we as healthcare professionals need to care about cost. Healthcare has become so expensive because we believe that more expensive yields better results. For example, studies have shown that there is no significant difference in wound bandages yet providers choose to use the more expensive option.
As Sammour argues, healthcare is not a luxury that only the wealthy can afford but a right that should be accessible to all. This perspective is supported by a range of ethical theories including utilitarianism, which prioritizes the greatest good for the greatest number of people and the principles of justice and fairness, which demand equal access to basic good and services.
From an ethical standpoint, providing universal access to healthcare is not just a matter of meeting a basic need but also of fulfilling moral obligations to promote the well-being of all members of society.
Dr. Sammour brings up a very interesting point about clinicians using all possible resources only because they are available to the them. I agree with him that there are currently medical practices in the US that may not be beneficial to the patient in the long run, but we use them because they are readily available. I believe that this violates the ethical guideline of nonmaleficence. The notion of nonmaleficence means that doctors have a moral imperative to do no harm. It implies that physicians will not provide interventions that are known to be ineffective, that they should act with due care and diligence, and that benefits and burdens should be evenly balanced.
In the case that was presented by Dr. Sammour, clearly there is no rationale behind using expensive wound dressings. As he said, this does not benefit the patient, which clearly violates the ethical guideline of nonmaleficence. Wound dressings that we commonly see in convenience stores seem like an insignificant cost to most of us. But in hospitals, the cost of these wound dressings may be astronomically higher. When clinicians use ineffective treatments, the cost is passed on to the patient. Cost of healthcare is a burden to patients, and in cases where physicians use non-beneficial procedures, the burden to patients clearly outweigh the benefit.
I believe that limiting the use of non-beneficial treatments, procedures, and medical resources will decrease healthcare costs. Hospitals and clinicians need to include cost of the procedure as a burden to the patient and reassess their thinking of quality over quantity. This is probably not the solution to the increasing costs of US healthcare, but it is a good place to start.
I would like to start by saying thank you to Mr. Sammour for sharing his knowledge with us and enlightening us with his years of experience that have led to this great perspective. What a fantastic discussion this is. One of the most controversial topics in healthcare today, and I think that Mr. Sammour “hit it out of the park”. His proposed 3 step plan towards the end of the video I think is great, however quite vague, and I hope to shed some of my perspective on the subject. In my advanced medical ethics course we talk very heavily about beneficence, which means to promote the most good for our patients. Now, I am personally in favor of private sector medicine, to an extent of course. I, respectfully, believe that private sector medicine has gone too far, and is starting to violate the principle of beneficence. I would like to take the perspective that healthcare is run too much like a business now. The fact is, physicians go to school for an average of 13 years, go hundreds of thousands of dollars into debt, and become doctors, which in latin “docre” means to teach. Physicians do all of this work to be told by somebody with no clinical experience how to manage our patients and I think this is why I think the principle of beneficence is being violated. The perspective is beginning to radically shift from “promote the most good” to “how do we make money from this”.
Mr. Sammour was trying to find the middle ground in the aforementioned statement. I believe that in the sprit of beneficence we need to start researching which procedures can be omitted and considered unnecessary in patient care in order to make patient care affordable from the patients perspective, not from the hospitals’ revenue perspective. This research will take time though because we need to ensure that risk never outweighs benefit when considering omitting procedures. I think that we as a society moving forward will find the middle ground and can achieve a compromise that keeps the patients and the hospitals prosperous with health and money. Thank you for reading.
All doctors are looking for more money. You say you are a fan of private sector, why? I mean all doctors want nowadays is more and more money. You cannot trust them because they are always looking to put you on medications or do a procedure to make more money off you. They do not care about your health in a private sector. This is why so many people are lost in the system in privately run health insurance.
It was very interesting to hear from Tarik as he has experienced living in a place where healthcare is seen as more of a right due to a different healthcare system versus in the United States where it is often a luxury because the government does not pay for everything and everyone In regard to the first point of the plan, select a system, I feel that it is much more complex than that, because for a country to change their system it would require drastic changes and agreement between lawmakers. I did however, appreciate the explanation between pros and cons of a private and public system and described how a hybrid system, combing both systems, is the ideal solution. The second point, caring about cost, is something that I feel we could put a lot more emphasis on because in America many people want what is high-end and new, but when it comes to health equipment and supplies just because it is older does not mean it does not work correctly or does not accomplish the same thing as a more expensive item does. Even something as simple as a band-aid, there are plan generic ones and then colorful character ones which are more expensive. Both accomplish the same task and although one may bring more joy to a child, they ultimately provide the same level of physical care so we should ensure that the more cost-effective method is available to patients, so they don’t have to undergo undue financial strain when it comes to bigger procedure as well. This can also be applied to the third point, quality over quantity, as if a procedure is done correctly the first time and doesn’t have to be repeated then the patient is being saved both time, money, as well as being respected. Something else that stuck out to me was when he said, “If something is a right, but as a society we can no longer afford to pay for it, does it then become a luxury.” From this it was implied that as a society it is under our control to determine if healthcare is going to become luxury or if it can remain a right. In my point of view healthcare should be a right, and not a luxury. One of the main ethical principles is justice which refers to the fairness of what people receive. If we are to be a society with justice, then I believe that it is only fair for healthcare to be something that everyone can access, no matter their wealth or status. Furthermore, in order to truly practice beneficence, advancing the patient’s good, healthcare has to be something that they can rightfully access because otherwise “good” or health cannot be promoted for that patient.
If you have insurance you never ask "how much is that test" that is why it's so expensive. PERIOD!!!!
Not really. I have insurance and I've been given bills for tests. Some of them extremely large and ridiculous. However, what most people ignore is that you don't have to pay that bill right away just because you get it. You can fight the insurance company over it, and argue that it was medically necessary or that you weren't told of this test. Heck you can just refuse to pay. It doesn't go on your credit and when it goes to collections, you just tell them you don't have the money. Tell them "I can pay 10% of that." They'll usually take it and they'll leave you alone.
Good speech overall. It is a very nuanced topic and it isnt at all easy to resolve. Not many important issues are.
It is pretty easy to solve, it's just americans make it look like it's hard
It is very interesting to have a view that is able to look at both sides of the coin. Also, that is able to acknowledge that on a global scale healthcare systems tend to be inefficient and prioritize people who are able to pay rather than giving equal care to everyone.
our health care system is like income eugenics.
There are a lot of factors left out of this discussion as you would expect with such a complex concept as healthcare. Just a few listed here off top of my head. Cost of health insurance due to medical malpractice and lawsuits justified or.not. An insurance system that does not promote patient knowledge of cost beyond their deductible payments or copay. Hospitals not telling patients cost of basic treatment like aspirin or bandages or even the horrible food they serve , I think brining down cost apart for requiring old people to die, should be our main focus
Dr. Sammour did an incredible job describing a position that is difficult to consider as an individual consumer. As he pointed out, as the patient we usually want the best care and if necessary, life saving measures to be taken. But if we consider the quality of life versus a quantity of life, we might as answer differently depending on the situation. He eloquently took a bird’s eye perspective of the pros and cons of both the public and the private health care systems that he has experienced in both the US and Australia. The ethical question at hand is justice. When we think about justice, it is about whether something is lawful, if it is a patient’s right, and if it is fair for the patient. Is there justice in providing marginal care for many or providing access to premier healthcare to a few? I think Dr. Sammour hit the nail on the head in suggesting that there is a balance in public and private health care. But have we agreed as a society, as least in the US, what the minimum health services are? When do we cross the line from right to luxury? This is what the healthcare reform battles in the US seem to be about. For example, is receiving insulin at a reasonable cost a right or a luxury? I think until politicians can come together to find a reasonable compromise between the two poles, physicians need to be transparent and be able to provide comparable alternatives to patients. This would require physicians partnering with their patients instead of taking a paternalistic stance. In addition, physicians should be having earlier conversations with patients discussing what a quality of life would look like for each of them. Many times, the highest costs of healthcare come at end of life. Being transparent and honest about these realities could not only improve our society’s views on healthcare but also the economics of it all.
i'd argue that private systems are much more inefficient - this is evidenced in the transformation of the NHS in the UK from a public to private system. The amount of middle management, and total spend on admin has grown massively.
Totally agree, and also what you said is literally just a fact, there’s nothing to argue. The guy in the video can stand there and say private is more efficient but it’s not supported by the data … what he said was total rubbish. What really gets me is that he even referred to statistics that clearly contradict it in his next sentence lmao.
‘Private is more efficient than public’
‘Also the USA spends more than any developed nation on Earth’
He has to pick one lol
Singapore is a great example of great healthcare financing, a good balance between the 2 extremes
I am grateful for the way that Tariks Sammour presented this TEDx Talk. The consideration of healthcare being a right or luxury is a question that policy makers are faced with around the world. I appreciated that Tarik provided pros and cons of healthcare systems in different nations, focusing on those that are set up with the mentality that healthcare is a right, compared to those that are structured as it being a luxury. The reason that this dilemma exists is because there is no simple answer. I do believe that there has to be a way to offer care to all without sacrificing the quality of care, as was briefly addressed in the talk. If the ethical principle of justice was considered as an overarching necessity in the development of healthcare policy, I believe that it could be accomplished. This principle is one of the four overarching ethical principles that physicians act under. This means that medical treatment should be fair and equal for all. How is a physician supposed to fulfill this duty to their patients if the healthcare system established is not supportive? No matter the structure of the healthcare system that is developed within a nation, it should allow a physician to treat the sick to the best of their ability, regardless of their economic status. I believe that a focus on justice would also shift many perspectives of physicians from the monetary bottom-line to their patients, promoting better healthcare. If anyone has any insight that would add a different perspective to this topic, I would appreciate a response.
"I remember when 'liberal' meant being generous with your own money."--Will Rogers.
Now it means idiots
Now it means being generous with other people's money...
@@JustBalazs *Soviet anthem intensifies*
@@JustBalazs By making healthcare free, we would spend less total of our money on health care.
Argon Hammer is this sarcasm?
I am a doctor in a poor brazilian region, and I work as a primary care assistant of the public health system we are proud to have here. If it wasn’t the SUS, we had had no chance to make the pandemic out
My patients have the chance of seeking medical care everyday, receive a diagnosis, a plan treatment and also, if needed, exams and they go out of the facility with the meds, ir they can caught it in the Popular Pharmacy, that is financed by the federal government, without cost (meds for hypertension, diabetes, asthma, heart failure…). There are too much difficulties in our health system, but i’m sure it is the brazilian most precious treasure and we have to fight to make it better
There is no wealth but life, one of the questions to be asked is what is and what should be the role of government? I like the sweeping assumption that the Public Sector is more compassionate; I'll wait for the evidence of that thanks Tarik...
Agreed. That same govt compassion brought us 100's of million being starved to death int he 20th century. If I want compassion I will definitely look elsewhere.
Healthcare is, like food, a universal need. If you are alive, you will need healthcare. If one person is denied basic healthcare (vaccines for example), the entire community suffers. You can play semantic games all day but this is not going to change.
Asking whether a basic human need, like healthcare, is a right or a privilege is deliberately misleading. It creates a false dichotomy - sort of like asking someone if she is a liberal or a conservative - as opposed to a person with a functioning brain.
In healthcare, we like to cite the Iron Triangle of access-cost-quality and pretend the tradeoffs are inexorable. However, that paradigm trade off assumes an efficient system.
In America, we do not have an efficient system. By most estimates, about half of our healthcare dollars go to rent seeking. We have a ton of rent-seeking intermediaries - most of which add no value whatsoever.
No insurance company every treated anyone for an illness or added any value for any patient - they are purely parasitic entities. Generally, they play dilatory games to prevent people from obtaining the care they need - all in the name of rent seeking. If you dispute this - answer a simple question - what do insurance companies produce?
No student-loan bank ever educated a student -they instead encouraged college and medical school tuition hikes - in the name of banking and university profits - and at the expense of a generation of students.
Many “nonprofits” are similarly parasitic. They are not interested in solutions - they are interested in making money by prolonging the problem. Ask yourself why the AHA promotes bacon and cheese products on its website - then check its list of donors - littered with meat and dairy companies.
No industry in the U.S. spends more money on lobbying (controlling politicians in the name of rent-seeking legislation) than the pharmaceutical industry. Big pharma hides behind the “R&D” justification for their absurd profits.
However, everyone in the pharmaceutical industry knows that most substantive R&D occurs in government labs. Pharmaceutical companies then cosmetically tweak and market the government developments for their own profit - and at the expense of the taxpayers who funded the research - lobbying dollars well spent.
Moreover, big pharma pushes drugs we do not need for problems we do not have (ADHD for kids, most psych drugs) or would not have (treating high cholesterol, diabetes, and other largely diet-related illnesses) but for big agriculture’s rent-seeking activities - pursuing subsidies for toxic food products. Read the China Study if you think a bacon cheeseburger is good for you.
Simply eliminating the rent seekers and adopting a uniform healthcare system - Beveridge (UK, France, Japan, and Oceania), Bismarck (Germany & Northern Europe), or Canadian Medicare - is not that difficult - almost every other western democracy has already done so. Most receive vastly superior outcomes and access, and all pay a far lower cost than we do in the U.S.
What do they all have in common - they cut out the rent seekers.
A nice side effect is that the governments in those nations are incentivized to keep their people healthy - so they tax bad stuff (tobacco and alcohol) and subsidize good stuff (education and the arts). Doctors do not have student loans. They do not pay malpractice premiums. They do not have a billing staff. They have far lower expenses and proportional salaries.
Government is also far leaner with single payer. Therefore, there would be no VA Healthcare, or Indian Affairs Healthcare, or Medicare for the old, or Medicaid for the poor. Everyone would just have the same healthcare - like most other civilized nations.
All those people employed by the insurance industry, lobbying industry, pharmaceutical sales, student loan industry, banking, and various health “associations” funded by big pharma and big agriculture would have to get jobs doing something that actually benefits society - instead of destroying it.
Most of the admin people would have to do something of value too. The bulk of health-related government agencies would be redundant too.
All those nonprofits lobbying for healthcare for different identity groups (race, gender, nationality, condition) would disappear too - because everyone would have the same healthcare.
Worst of all, all those medical malpractice attorneys who represent the most sympathetic 3% of cases of people harmed in malpractice incidents (and rejecting the rest) would have to find something useful to do if we adopted an administrative claims system for med mal.
Most western democracies have an administrative claims system because they are far less expensive and fairly compensate far more victims more efficiently. In addition, a national administrative claims system makes it easy to eliminate the bad doctors from the practice pool.
Still - those poor lawyers - what would become of them?
Gosh, it is a painful thought - the elimination of useless rent-seeking entities. Never mind - status quo it is.
P.S. - I got my grad degree in health policy from Harvard - where did you get yours?
👏 This post deserves far more likes 👏 Thank you for your service!
This is not even debated among informed people who aren't directly or indirectly on the payroll of one of the aforementioned rent seekers. Every other civilized nation on the world has figured this out. The U.S. just has too many pigs at the trough.
plsss help my homework lol im fairly new to the idea of healthcare and stuff so is private health care bad and how is public health care better?
Most public healthcare in the world are in fact hybrid like the Australian system (most of European countries like France or Germany, Japan, etc...).
The truly "socialized" healthcare are not so many (the Uk or Canada).
I whole-heartedly agree. Healthcare is a topic that touches the lives of every individual, and the question of whether it is a right or a luxury is a crucial one. As human beings, we all have a right to good health and wellbeing. Denying individuals access to healthcare can have serious consequences for not only them but for society as a whole. People who do not have access to healthcare are at greater risk for chronic diseases and illnesses, which can lead to increased morbidity and mortality rates. This can have a negative impact on economic productivity, healthcare costs, and social development.
Additionally, healthcare is not just a matter of providing medical treatment for those who are sick. It is also about promoting healthy lifestyles and preventive measures to reduce the burden of disease. Universal access to healthcare services can help to improve health outcomes and reduce health disparities among different population groups. Often healthcare is inaccessible to the most vulnerable communities and populations like people of color, low income individuals and those with disabilities. Not supporting a right to healthcare for all only further extends the gap in equality and perpetuates poverty. These groups are more likely to suffer from illnesses that are preventable and chronic illnesses. Studies have consistently shown that individuals living in poverty or with low income have a much higher chance of developing chronic diseases such as hypertension, diabetes and obesity. Creating a universal basic healthcare system can help alleviate the stress that is placed on these groups.
Medical ethics and principles of social justice support the fact that healthcare is a basic human right. As healthcare professionals, it is our duty to provide care to all individuals, regardless of their ability to pay or social status. This is reflected in the Hippocratic Oath taken by medical practitioners.
Healthcare is not a luxury but a fundamental human right. We must work towards creating a system that prioritizes the health and well-being of all individuals, regardless of their background or financial status.
Imagine living in Australia and not having to pay 50k for stubbing a toe
Hmm, I live in the U.S. and i don't recall having to pay 50k plus for stubbing a toe
@@peakhelliw1509 my mom did.
@@peakhelliw1509 not 50k but more like 5k.
@@liberalbias4462 Show us the proof that your mother spent $50,000 for a minor toe injury.
@@baja1988_Texas how am i suppose to do that it happened when I was 6.
The problem in the US is we use the excuse that it's not a right, which is correct...but that's because we *CHOOSE* to make it not a right - that's the part they leave out in the conversation. We aren't arguing that it IS a right, we are arguing that we CAN make it a right, and we should.
No
@@westg463 a family member of mine got declined... that family member was dying from an overdose at a rapid pace... they almost lost their life.
Dr. Sammour brings up a very interesting point when he talks about the cost of healthcare. He poses the question do you want your doctor to be worrying about the cost of everything around them when operating or the rather the task at hand? I would argue I wouldn’t want my doctor to be thinking about the cost during the operation but that doesn’t mean the cost of treatment is never discussed. I believe Dr. Sammour makes a strong argument when he states that we as healthcare providers and patients need to be talking about the cost and why. This is a great example of the ethical principle of beneficence which physicians make an oath to uphold. Beneficence states physicians provide benefits to persons and contribute to their welfare; in simpler terms ‘do good’. Physicians need to take into account the cost of treatments without decreasing the quality of care. Dr. Sammour mentions that physicians and patients should stop equating price with quality of care. Medicine is not a one size fits all. The care that is provided is different for each and every patient. The great thing about medicine is that there are many different avenues that can be taken and it does not need to be a one size fits all situation. Patients and doctors need to have the difficult conversations in this case about the cost of treatments.
I find the debate of whether or not healthcare is a right or a luxury to not be as important as many people who argue about it make it seem. I appreciated how Dr. Sammour ended his talk by pointing out that whether or not healthcare is a right or it is a luxury, it’s becoming more and more inaccessible either way.
Healthcare is a complex and expensive industry, requiring significant investments in research, technology, and infrastructure. As a result, healthcare services can be costly, and may only be accessible to those who can afford them. High healthcare costs put a significant burden on individuals and families. Many Americans struggle to afford healthcare, with some even choosing to forego necessary medical care due to cost concerns. This can lead to untreated illnesses and chronic health conditions, which can have serious long-term consequences for individuals and their families.
The increasing cost of healthcare needs to be addressed. I’m not going to pretend to know anything about the economics of healthcare in the United States, so I’ll leave the debating over different healthcare systems to people who actually know what they’re talking about, but I am willing and ready to listen to proposals of how to change our healthcare system in a way that makes this service, right or luxury, more available
Access to quality health care should be affordable for all in an ideal world.
Many politicians in America always point out the failures of countries with free healthcare; long lines, poor service, etc. However, and not to criticize other countries, but who is to say that America couldn't create a better system by learning from the problems of these countries instead of just saying it won't work.
For the same reason all those countries could learn from each other (and probably have tried many different ways), and still remain failures compared to America
@@Alextrovert America ranks worse than many other countries with socialized medicine
@@Alextrovert you obviously suffer from the crippling disorder called American exceptionalism,in international league tables measuring health care America scores in the mid twenties,so not the best.
How do I send this to humanity
Yeah but
I still believe the NHS model
Is the best
its not(i live in london btw) nhs scotland is, the have the most efficient and best model for the people, the nhs england model is privatised and such a mess
India has introduced a system called the PPP - Public Private Participation that has brought the latest diagnostic equipment to public healthcare facilities.
I have great respect for Dr. Sammour's willingness to address such a difficult topic. There is no question that healthcare is getting better as shown by the profoundly prolonged average lifespan compared to what it was even 50 years ago. But the unfortunate side is that while it is continuing to get better, the costs surrounding it continue to increase. This presents a difficult ethical problem that Dr. Sammour addressed when he said that if we want to have government-funded, perfectly equal healthcare for everyone, we have to be ok with other things such as the death penalty. There does not seem to be a good clear answer to this difficult situation. When posed with the question of healthcare as a right or privilege, my initial inclination is to immediately answer that it is a right. Suggesting otherwise is to say that one person is allowed to live and another dies only because the one who lived had more money. This sounds like a terrible violation of moral ethics, but on the other side, would science and society continue to progress if healthcare funding was standardized (and surly decreased)? Here's my idea (keep in mind that I am just a guy on the internet). What if everyone had an allotted amount of government funding that they could use specifically for healthcare? Sufficient funding to cover easily treatable, but often fatal diseases (i.e. appendicitis). Or midlevel care for more difficult diagnoses like cancer or autoimmune disorders. That way everyone could at least have access to some type of care.
Dr. Sammour does a wonderful job presenting the issue of private vs public healthcare systems that allows a realistic perspective that the perfect healthcare system does not exist. He states that there is a choice to have mediocre care for all or good healthcare on tap for those that can afford it, but I would argue that there is hope for a hybrid system. The issue is that those at the top have to be willing to fall to some degree to allow the whole system to rise. Having access to GOOD medical care should not be a privilege, it should be an option. That being said starting with small strides can make a large impact.
Many people believe cutting physician salaries and raising their taxes will help with healthcare costs, but have those people seen a surgical bill revealing what the physician has been paid vs what has been charged the insurance? Is it ethically sound to charge someone thousands of dollars for a procedure when the physician doing the work only gets a small fraction of that?
Starting small with something so simple as using the research we have on supplies such as the surgical bandages providing no long term protection against infection and improvement in wound healing. This was such an interesting point. Could we standardize supplies to ensure that all healthcare companies were provided the cheapest option on a product that still serves it’s purpose and meets a certain quality? Companies that are profiting off of inflated prices on healthcare equipment should be where we are looking to.
Like digga
Health care is like food. It’s a necessity. It’s foolish to say.... food is a right.
why is that foolish?
@@kalekoibecause it's big camera flashlight
From a purely legal perspective, Healthcare is largely considered a privilege, BUT, it SHOULD be a right.
Life expectancy is actually decreasing in the US. It’s significantly decreasing in certain regions.
in the USA, companies like aetna abuse their huge corporate power while barely servicing their clients. it's expensive, but definitely not a luxury since you get almost nothing in return. rights should not bankrupt you and make you suffer. the whole system needs to change.
This talk that Dr. Tarik Sammour provided was an interesting perspective on an age old argument. If I was initially asked on whether healthcare is a right or a luxury, my immediate gut reaction would be that healthcare is a right. This idea largely stems from the ethical principles of both non-maleficence and justice. In the realm of justice, it’s believed that all individuals that enter a hospital or clinic should be treated equally and equitably. With that in mind, by not providing access to care to individuals, one could argue that this would go against both justice and non-maleficence (aiming to do no harm). However, an interesting point that Dr. Sammour brought up was the healthcare system’s goals in prolonging life without consideration of quality in life. It could be argued that if all individuals receive care to prolong life, but that life ultimately ends in living in pain, financial debt, and isolation, is it truly respecting the ethical principle of justice?
Dr. Sammour also brings up the idea of appreciating the financial value in the tools/technology we utilize when providing care while also understanding when to cut costs. Bringing back this idea of prioritizing quality of life, it makes me wonder whether the American healthcare system should learn to cut costs in materials whose quality does not bring value and redirect those funds to supplement other aspects of healthcare. Specifically, I believe that putting in funding for nursing homes and assisted living facilities could be a way to increase our patients’ quality of life. Personally speaking, I have seen nursing homes that have been understaffed and overworked. By increasing funding, perhaps these organizations can provide increased quality of care to their patients while also increasing access to activities that promote socialization and mental/physical stimulation. Thus, prioritizing quality of life over simply prolonging life.
As Dr. Sammour suggests, I believe that the healthcare system has further work to do in finding a balance in improving access to care without neglecting the quality of life.
your tidbit of richness could not be invested any-better than into knowing the people of your country being generally-well.
For years people have been debating whether healthcare is a right or a luxury. Some people argue that the right to healthcare is a basic human right while others say that it is a luxury that people should pay for themselves. Those that believe that it is a right think everyone should have access to healthcare regardless of their financial situation. They would equate it to the right to food, shelter and clothing and that the government has a responsibility to provide those services to every citizen and be free/affordable for everyone. The World Health Organization (WHO) states that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being."
However, there are other people that believe that it is a luxury and you should be responsible for your own expenses as if it is a commodity that someone can purchase or not. It is believed that this facilitates competition among healthcare providers to provide better quality and more affordable healthcare services.
While both sides have valid points, the best solution lies somewhere in the middle of both of these extremes. It is fair that healthcare is a fundamental right and be able to be accessed by anyone but healthcare is an extremely expensive service and requires a lof of financial resources. It is imperative to find a balance between providing universal healthcare while also making sure that providers have the resources to be able to provide the best quality service.
The United States has the type of healthcare that is more of a commodity rather than a right which expects people to pay for their healthcare services through private insurance. But, this can lead to people not being able to afford the treatment they need and leaves many without access to the appropriate care. Other countries like Canada and the United Kingdom have universal healthcare that off free or affordable medical care to all of their citizens. The downside with this is that they can have long wait times for procedures that are not emergencies.
Overall, there are valid arguments for both standpoints but healthcare should be accessible to all individuals no matter if they can afford it or not. Healthcare is a basic life necessity in order for people to lead healthy and productive lives and I believe the government should make sure that is possible for all. Healthcare shouldn’t be seen as a luxury only available to some but rather accessible to all.
I feel like the true answer to is healthcare a right or luxury depends heavily on what area of the world you live in. For example, Tarik was talking about how when looking at a job in the United States as a physician from Australia, his two kids, who were the poster child of health, still cost him around $25,000 per year to insure. What if he messed up the paperwork or couldn’t afford the premium? What would that have meant for his children if they got sick or needed any healthcare services whether that be acute or chronic? The United States is one of the richest nations economically and with that comes access to top-of-the-line technologies and resources across multiple areas, especially healthcare. And as a citizen you could have access to all of this amazing medical care to give yourself the best chance at surviving whatever medical condition you are going through, but it is at a cost. A very high cost that excludes many of people. So yes, you can have the best medical care, only if you could afford it.
I have also felt the similar dissonance and difficulty that Tarik had felt and experienced during his time in the United States healthcare system. We train to be doctors and sacrifice many things personally, professionally and financially at the opportunity to make a difference and help patients. It’s a sobering reality when we realize that this passion that drove us to go into this field is limited to the types of patients we can reach. We want to “do good” and “do no harm” to all patients we encounter as healthcare professionals, but are we really doing no harm by not giving healthcare access to the people who need it the most? A healthcare model that is exclusive and difficult to be a part of. The United States healthcare system reminds me of a top 100 golf course. You have to know someone on the inside as well as have the money to back it up in order to be part of the club. So that begs the question, is healthcare a right or luxury? Deep down I think we can all agree that a certain level of healthcare is a basic human right it’s just the logistics of this notion that makes it complicated and ambiguous. It seems like the two options are either resource limited healthcare for everyone or resource rich healthcare for the wealthy. Why are costs so high? I want to echo what Tarik said in that yes people are living longer with less quality of life which increases their healthcare needs substantially in the last decade of life. I agree that the hybrid system model (e.g. Australia) performs better over time compared to their extreme capitalistic and socialistic counterparts. We can agree that spending less with better outcomes is more than efficient. My favorite point in the presentation was Tarik encouraging healthcare providers to pay more attention to what things costs as well as being up front and honest about disclosing prices to patients. If each of us healthcare providers were more mindful and cut out little things that were either a waste or unnecessary, I think everyone would be shocked at the financial impact it would have on the system and the patients. Isn’t that the essence of “doing good” for our patients? Doing everything in our power to make sure they are well taken care of in a capacity to which they can sustain and afford?
Dr. Sammour brought up an interesting point of view of one of his colleagues that he had an interaction with. Healthcare continuously gets more expensive for patients to have access to and get quality healthcare for themselves and family. I feel there is an ethical dilemma with this, the right to health and the principle of distributive justice. On one side, many people would argue that healthcare is a basic human right and that every person should have access to affordable healthcare. This is based on the idea that every human being has the right to a healthy life and healthcare would be essential for achieving this goal. On the other side, some argue that healthcare should be earned rather than a right or guaranteed. They would believe that people should have to work and contribute to society to earn the privilege of receiving healthcare. This is a complex ethical issue when we consider the fact that access to healthcare is linked to social and economic factors, like income, education and social status. Dr. Sammour made a lot of good points on how either a more privatized or socialist healthcare system is not as efficient. We could approach this question by creating a hybrid system between these two types of healthcare systems. His idea of being aware of the cost of equipment is really interesting and could eliminate some unnecessary costs like the wound dressing he mentioned. His last point of quality over quantity of patient’s lives. Quality of life for any patient at a reasonable cost should be a high priority for patients as healthcare continues to get expensive for people to afford.
Как круто!
Healthcare in one way or another is something that every single person on this planet will need at one time. Many regards healthcare as a basic human right to which each and every person should have access to regardless of their financial status. Moreover, access to adequate and good healthcare is essential to living a happy, healthy and productive life. Denying this right based on financial considerations is morally and ethically wrong. Healthcare without a doubt is a basic human need, much like food, water and proper shelter is. It is not a question of if but when a person will fall ill or sick at some point during their lifetime. When this occurs often times, they will require medical attention to fully recover from this illness. This simple example shows that access to healthcare is not a luxury but in face a necessity for everyone’s life. Denying such access can have dire consequences on health not only on the individual but also the community itself. The World Health Organization (WHO) itself states that healthcare indeed is a basic human right and everyone should have adequate access to it regardless or race, socioeconomic status, or religious beliefs. Providing the best healthcare to a community ensures equality and social justice by allowing every individual equally opportunity to lead a healthy life. Denial of this right based on social status or financial reasons is unjust and would without a doubt lead to disparities in healthcare outcomes. Reiterating on previous statements, providing adequate access to healthcare is essential to promoting community well-being and public health. Access to healthcare promotes individuals to seek medical attention when one may fall ill. Helping to prevent spread of diseases within the community and thus improve overall health outcomes for members of the community This benefit to a society as a whole will help to reduce the overall cost of healthcare to the community while also enhancing the quality of life to individuals in the community. Healthcare access is without a doubt an ethical issue that requires moral obligations to provide care to those who need it most. Medical providers should lobby based on the oath we all take to provide care to all regardless of their financial status. Denial of this right is wrong and as we a community should explore new options to ensure each and every person has the ability to access healthcare no matter their situation.
Age is something that happens to all. Nobody can stop time. Resource allocation however can be controlled.
what about children who get cancer?
Marisa Beltran like is said, age. Cancer is simply cells reproducing in a irregular manner over time. And cancer can be treated for many ppl if not most, but it has to accessible
@@NotShowingOff yes we are all gonna die, I know, it's just not fair how money dicides who dies sooner when it could be prevented 😔.
Thank you for this talk. You made some very good points and I appreciate your humor and good-natured delivery despite the controversial topic. I am an American medical student and there are a lot of things about the American system that are concerning to me. I am very much opposed to fully socialized systems because it is still ultimately very costly to citizens in the form of taxes, and the quality and availability go way down. I agree with you that the cost of healthcare in the United States is astronomical and something needs to be done about that. I would disagree with you though. We actually do have a lot of socialized medicine in the United States, it is a hybrid system, not fully private. This is partly, in my opinion, why healthcare is so expensive in the United States. Our socialized programs such as Medicaid and Medicare are tax funded government safety nets for the elderly, impoverished, and children. There is not a child in the US, as you say, without parents or with impoverished parents who is not eligible for Medicaid and thus free access to all high-quality healthcare that they may need. The truly disadvantaged in the American system or the middle-class people who do not have unlimited wealth to pay for whatever healthcare they need, but do not qualify for the government safety nets. I would even include the speaker in this TED talk in that category. Yes, he is probably making 500-600 thousand dollars a year working as a surgeon in the United States, but of course he is still going to feel the sting of having to pay $25,000 a year for his health insurance. But not nearly as much sting as he would feel if his taxes went from 40% up to 60% a year in order to pay for a socialist system. There is a reason he is choosing to practice in the US. Not to mention, if his child had cancer, I’m sure he would gladly pay the $25,000 a year and have his child treated in “the world’s best cancer hospital” that is incidentally in the United States. Now, quickly back to why healthcare is so expensive in the United States. I agree 100% with the speaker. The costs of healthcare need to be made way more transparent. Nowhere else in society would you buy something without looking at the price tag first. The prices need to be transparent and made standardized. Standardized prices would prevent private insurances and government safety nets from dictating price by only paying a fraction of the billed price. With standardized prices, the negotiation between hospitals and insurance companies over reimbursement would go away and prices would stop being driven up by these negotiations. I also believe that physicians should own and more hospitals and be in executive roles, while still attending to some clinical duties. They must look the patients in the eyes and make treatment plans and they will be more likely to see patients instead of profits. Business executives can easily slip into the trap of fixating on their bottom line.
2 things completely overlooked. The revenue evacuated by capitalists that also dodge huge tax Bill's could pay not only for free healthcare world wide but also other much needed use values. Secondly food and lifestyle choices cost the healthcare services or insurance companies etc billions . Pro ote a healthy lifestyle and you could prevent MOST chronic diseases
Money makes the world go round, not surprised since it's created in the birthplace of capitalism.
Mandated health in society means say goodbye to lots of companies and industries like candy, bakeries, cereal, fast food, soda, meat, cheese, tobacco, alcohol etc.
@@ConsiderTheCrows we’ve already been saying goodbye to some of those for some time. Tobacco is probably the worst, everything else in moderation is either harmless or actually good for you. For example, our bodies actually do need sugar to survive… we just don’t need a bottle of coke every night with dinner. In Australia, the inclusion of nutritional information on the label of every product has helped consumers to make healthier decisions… we just need more policies to teach moderation. I would refer to the French education system, where kindergarten students are taught from about the age of 3 how to sit at a table and how to eat food. They are given a couple courses of home cooked healthy food and taught not to eat quickly, to eat a varied diet, and not to keep eating once they are full. Kindergarten is also paid for by the state. It’s these sorts of policies all working together at every level of society that can help us imo
I feel like healthcare is a need not a right or a luxury, it’s just like breathing or water we need it and it helps us survive. I currently do not have health care nor do my family members and, it’s really tough sometimes we can’t even afford to go to Starbucks I wish it’d be easier to access. Doesn’t even have to be free just less expensive:/
Healthcare is right as written in my constitution
Dr. Sammour makes several excellent points regarding the two predominant perspectives taken regarding healthcare in western countries, namely, the approach to healthcare as a human right or the approach wherein healthcare is a luxury only for those able to afford it. While the principal of beneficence in medical ethics constrains a physician to act for the benefit of the patient, a physician would be upholding this principal in either case described by Dr. Sammour. They might be working for the benefit of the few and privileged who can afford their care under a system constrained by private health insurance, or they might be working for the benefit of all members of their society if they so happen to belong to one offering free healthcare. In both cases the physicians themselves are upholding the principal of beneficence. What if, however, healthcare providers had a more utilitarian approach to providing healthcare? What if the goal were to provide the best possible care to the greatest number of people possible? Dr. Sammour alludes to this in his final comments as he suggests taking what we can from each of the established approaches to medical care and creating an approach to healthcare that would assume healthcare to be both a right and a luxury. By approaching our understanding of the ethical principal of beneficence through the lens of a utilitarian, we can make it our goal to make changes to our current system that would still allow for innovation, while simultaneously increase the number of individuals who have access to that care. It may require a shift in how we as a culture view life and death in terms of quality and quantity as Dr. Sammour suggests, but in making that shift we may set the stage for a system of healthcare that provides excellent care to all members of its society.
While it is important to consider different perspectives on healthcare, the argument presented in this comment is flawed. Utilitarianism is a consequentialist ethical theory that prioritizes the greatest good for the greatest number of people, but this approach has its limitations. The utilitarian approach to healthcare would involve making decisions based on cost-benefit analysis, which could potentially result in sacrificing the quality of care for some individuals in order to benefit the majority. This approach may also result in neglecting the needs of vulnerable populations who may not have the means to access healthcare.
Moreover, the argument overlooks the fact that healthcare is a basic human right that should be accessible to all individuals regardless of their financial status. A healthcare system that treats healthcare as a luxury for the privileged few undermines this fundamental right and perpetuates social inequalities.
While it is important to consider the practicalities of implementing healthcare policies, the ultimate goal of healthcare should always be to provide the best possible care to all individuals, not just the majority. A system that prioritizes the utilitarian approach to healthcare may end up sacrificing the rights and wellbeing of individuals in the pursuit of maximizing benefits for the majority.
In conclusion, while it is important to consider different approaches to healthcare, the utilitarian approach is not a viable solution to providing equitable and high-quality healthcare for all individuals. Healthcare should be viewed as a basic human right and policies should be designed to ensure that all individuals have access to affordable and quality healthcare.
@@JamieLaSala First and foremost, I want to thank you for responding to my comment and providing me with an additional point of view on the topic of how we as a society should view healthcare. After taking some time to consider your thoughts regarding the unintended consequences of implementing a Utilitarian approach to healthcare, I must say I agree with you. Many of these concepts are still new to me and I am doing all I can to develop a better understanding of how our healthcare system operates here in the States, and what changes might promote better health outcomes for those seeking medical assistance. I feel that it may have been a little naïve of me to assume that a single philosophical approach, in this case Utilitarianism, might be able to resolve the complex problems inherent in our current healthcare system. What I was trying to express was a desire for a solution to both the problems of continuing quality and progress in healthcare, as well as the problem regarding the availability of healthcare. I too feel that healthcare should be a basic human right, and hope that as a society we continue to push that value to the forefront of our political discourse in the hopes that together we can find a way to provide quality care to everyone who needs it. In offering Utilitarianism as a possible path forward, I only hoped to convey my desire for the best possible outcomes for as many individuals as possible. I do feel that however the issue is approached, consequentialism will be an inescapable issue to contend with. To what else would we direct our attention and efforts if not the intended consequences we seek to accomplish? This is a very complex issue, and the components involved are both nuanced and multifactorial. In striving to articulate the problem, and by setting measurable goals to solve them, we can hopefully uphold the high ethical standards that currently guide medical practice today. Whatever philosophical approach we take, I hope it is one that directs our efforts to achieving the greatest possible good, for the greatest number of people without having to sacrifice quality of care provided to any individual patient.
I chose this TedTalk just based off of the title. This is a topic that I am passionate about, and I think should be discussed by those in or going into the healthcare field. From an ethical perspecitce, it is important to think about the ethical prinicpal of Justice where as health care providers we are there to equablly distribute benefits, risk, costs and resources to all of our patients. That can make it hard to have a tiered system as not everyone can afford the highest of the levels which goes against the that justice principle. I wonder if there is a way we can help “level” the “playing” field. I think that it is going to be hard to do in one go, because it has become such a web here in the United States, where there are many people especially in politics that deal with these decisions. There was another point that Dr. Sammour made when he said that as healthcare providers we need to start protioritzing quality of ones’s life over the quantity of their life. This plays into the ethical principle of Beneficence, where we act in the benefit of our patients which means being proactive in their health care, and helping improve their day to day lives.
I think what you’re trying to explain is the ethical concept of distributive justice, which is economic justice. This is about fairness in what people receive from goods to attention, i.e. who gets access to high quality healthcare. I agree that if society goes by a tiered system, that this would go against the ethical principle of justice, since individuals who have more money will have better access to healthcare. However, Dr. Sammour did make a good a point about how it’s impossible to provide equal universal high-quality healthcare, since the cost financially is too great. Thus, if one’s society provides universal healthcare, then all the individuals in that society will receive mediocre healthcare, which may include a long waiting list for necessary services. This provokes the thought whether universal healthcare offers beneficence or maleficence. On one hand, universal healthcare will promote good by providing healthcare to individuals who otherwise could not afford it. However, on the other hand, universal healthcare could be providing harm by setting back a person’s interest for obtaining high-quality healthcare. This then leads us to what Dr. Sammour said about how we as physicians need to start prioritizing one’s quality of life over their quantity of life.
Wow, love seeing debates of first world countries of having to choose between 85 years and better quality or 92 years and a worse quality
Meanwhile, in my country I've seen some toilets cleaner than our public hospitals
What country if u don’t mind me asking
An interesting solution is having each state decide what healthcare system it uses, resources would not need to be spred as thin.
They never do this things.
@@thomast3570 Yah, I know.
The answers are not really simple. The question also becomes expanded to: Should we deny healthcare to a diabetic neighbor who then develops severe ketoacidosis and crashes into your children car leaving them paralyzed for life. Healthcare is like Defense/Security: Should it be private, outsourced, public, shared, neighborhood watched, etc. Each has its own problems, but how can it be monitored and corrected? To what extent is regulation necessary for preventing excesses and when does regulation become an excess - wasteful and self-serving?
Is it OK to deny healthcare to a young 15-year-old with terminal cancer to prolong life by 5 years with all the problems encountered in the 92-year-old example? Why are there escalating costs that no one can control? Part of the problem is that the healthcare system has taken a life of its own and just like HAL in 2001 a space odyssey, it believes in the self-preservation and growth, regardless of the effects on society. Ony, it is far more pernicious. Its functioning is completely opaque with layers of questionable administration and other costs. The US healthcare is not private, it is a weird hybrid where people in their productive years pay for private insurance subsidized by tax incentives by the government to barely use the funds towards care needs. After retirement, this system vanishes and gives way to a system that pays for the most use of healthcare utilized, largely at taxpayer cost. The system also defines limits to drive patients towards the total bankruptcy in approximately the last 20 days of their life. Simple technologies that should become cheaper with competition and time stagnate. It is really not about kids in a candy store. The common patient is not necessarily looking for bulky luxury Cadillac, but no one is presented with the option of a working Toyota Corolla.
The question that Dr. Sammour posed was: is healthcare a right or a luxury? This is a challenging question as any good-hearted person would not want to willingly withhold medical treatment for a person in need. It is critical that we look at this matter through an ethical lens. There are four pillars of medical ethics which are: beneficence, non-maleficence, autonomy and justice. While healthcare access involves many of the ethical pillars, the one that is most evident is the concept of justice. Justice is ensuring fairness for patients. In order to ensure fairness for all patients, healthcare must be considered a right and not a luxury. If healthcare was categorized as a luxury, this would deny certain demographics of healthcare. The demographics listed previously would include minorities and lower socio-economic individuals. A counter argument to viewing healthcare as a luxury and not a right is as followed: It is demonstrated that having free and public healthcare to all citizens of a country may decrease the quality of the care provided. Some argue that if healthcare is granted as a right, patient compliance decreases since they are not actively funding their medical care; thus, making them less of an active member of their care. It is important to establish that patients will continue to have autonomy regardless of whether their healthcare is provided without cost. Patients will still maintain the ability to decline or elect to seek medical treatment. The concept of ensuring patient compliance is not the responsibility of the medical system, rather the responsibility of each patient. This argument falls flat from an ethical perspective.
Considering medical care is a basic human right supports the medical ethical pillar of justice. Allowing patients to have full access to health care regardless of their financial situation ensures fairness.
Either way, I see healthcare as more of a right that should not become a luxury, but is. However, many people in the comments have convinced me that healthcare is fundamentally neither of those things and really just a necessity. August 22, 2021, 11:30pm
Generally I agree with Mr. Tarik Sammour, except for his point about using cheap wound dressings because "cheap works just as well". If doctors would make just a little effort to bring themselves up from the dark ages about wound healing and care instead of reading all the funded, heavily bias and poorly designed studies about dressings, maybe we wouldn't have such a huge problem with hospital acquired surgical site infections and chronic wounds. The answer is NOT to go back in time. The answer is to understand how to get the best bang for our buck. We need to know how to get the best performance from the equipment and supplies we use. (Every time you change a dressing you cool the wound and slow the healing, a quality dressing can cost about 2 bucks, be left on for a week and provides the best possible environment for healing to take place? Where as cheap gauze and tape costs about 50 to 2 dollars depending on how waste by the caregiver using it, is a perfect host for bacterial growth, must be changed once a day)
But more importantly, we need to work on the economic and political forces that are driving up the cost of care, such as forcing medical device companies to spend hundreds of thousands of dollars for FDA approval and the subsequent "reimbursement" to stakeholders, just to name one. There is a significant chunk money being siphoned out of the care system and into the hands of people who dont provide care or even care at all!
Healthcare is getting better overall for everyone. The amount of people that can afford it on tap, is increasing.
J U thanks to the aca
Access to good health shouldn't be seen as a right or a luxury. It's something humans need.
i was born in the US but 2k for an xray while they call you a pansy for it. i once got an inch shard of glass in-bedded into my pointer finger fully under the skin next to the bone on the palm side at the knuckle, they made fun of me the whole time until they operated on it they they where surprised like damn! yeah you wouldn't have been able to get that out yourself, but i got a bill for 3k+.
I think Dr. Sammour articulates some great points here. Like most things in life, the happy medium between complex issues is generally where the ideal solution to a problem is. From an ethical perspective, however, I think the question of justice to patients of our healthcare system is the biggest element at play: Are patients getting the best care they can receive in a more tiered healthcare system or a more socialist-based healthcare system? On one hand, free healthcare for all results in mediocre healthcare at best for everyone. Yet, in a tiered system, those who can afford it do have access to top-of-the-line care. And unfortunately, there really is a finite number of resources and practitioners available to provide care. Thus, there is one important factor that I believe should be considered in this analysis: how we as people also directly impact our own health in our lifestyle and the decisions that we make. There are certain lifestyles/choices that have proven to be associated with deleterious health effects ranging from physical injury to untreatable infections and diseases. This is not at all to imply that people who make decisions (intentionally, unintentionally, or apathetically) that negatively affect their health should be left out to dry OR that some medical conditions aren’t simply inevitable. But rather, that the cost of medical care should be better accommodating for patients who generally live more health consciously AND we as medical professionals must educate our patients thoroughly about these associations, big or small. Hopefully this will in turn, encourage better lifestyles/choices that support better health outcomes and less need for extremely specialized, nuanced, and advanced care.
In his talk Dr. Sammour discusses about 2 ethical principles. To start with the obvious, he discusses about distributive justice. This is fairness in what people receive. Although the public system that he discusses provides fairness in healthcare across the board, there is the discussion of monetary costs for healthcare; therefore, the quality of healthcare decreases. This is where beneficence comes into play which is to promote good. If there is a lack in quality of healthcare, then is that fulfilling beneficence? Now, to the privatized system which lacks in distributive justice, but increases the quality of healthcare due to having a massive number of resources which could be argued to promote beneficence. However, Dr. Sammour argues that the best healthcare system is one that balances both. Which by utilizing ethical principles, this would promote beneficence and also would have distributive justice. One specific point he made that I would like to focus on is the quality of life vs quantity of life. This goes towards beneficence which means to promote good which can be up for debate as to what is good, but I agree with Dr. Sammour in that preserving life for the sake of quality rather than quantity is key in a good healthcare system. I believe this is good and if a patient feels preserving their life in order to live longer is better than that can lead towards beneficence as well, but society should not be chasing this idea of “immortality.” In an ideal healthcare system, the quality of a person’s life should be prioritized.
I think it is very difficult to discuss whether healthcare is a right or a luxury with an unbiased opinion, but Tarik Sammour does a fantastic job analyzing both sides to the argument. Economics and politics now play a large role into the aspect of healthcare, and most countries have adopted the extreme ends of the spectrum between healthcare for all and healthcare for those who can afford it. This directly relates to the medical ethics principle of justice, which refers to a fair and equitable distribution of health resources. Universal healthcare aims to provide this type of equal access to resources, but as Tarik points out, there is a lack of good qualitative outcomes. How as a society can we find an equal balance between high-quality and affordable healthcare? Ensuring equitable access to healthcare, especially in countries like the United States, would be one of the most expensive acts of justice to date. I really appreciate the point Tarik made about the longevity of individuals nowadays with all the advances in medical technology. Just because we can extend someone’s life, is prolonging the inevitable really going to make a positive impact? With most of our healthcare expenses going to the 85 and older population, how might we judge what is considered “equitable access,” when these individuals require more than the average? On the other hand, privatizing healthcare would certainly continue to produce advancing technology for these individuals but would only be available to the ones who can afford it. If you are a physician and know of a live-saving medication for your patient, but they cannot afford it, what do you do? Violate not only the justice principle, but also the principle of beneficence and not administer the medication? Or save the patient, but with an associated cost? The balance between doing what is right and doing what is economically justified may never be found, but I believe that if we, as a society, find a common ground on the stance of healthcare, we might be one step further to obtaining this balance.
In this talk Dr. Sammour does an incredible job of highlighting a major problem in the United States and provides what seems to be an appropriate solution to the conflict of universal healthcare. While highlighting the expenses and outcomes of healthcare in the United States, he compares costs and outcomes with nations who follow a socialist, healthcare for all, model. The benefit of this model is that it follows the ethical principle of equity, as everyone is provided the same level of care, options for treatment and physicians. While this model may sound appealing to some, it also comes with long wait times to be seen, limited choices in healthcare decisions and provider decisions. Those in favor of the USA model of healthcare argue that individuals should be able to make choices surrounding their healthcare, even if that choice comes at an astronomical price. The socialist healthcare system also follows the principle of beneficence, as there is healthcare being provided for the greater good of the nation. The American healthcare system breaks several of the ethical principles, such as equity, as individuals must pay for many things that they wish to have which creates an economic disparity within the country. While the USA provides Medicaid and Medicare, many states have limited resources toward theses programs. These programs also limit one’s ability to choose their provider and when to be seen. It should be noted that Dr. Sammour discusses how Australia has a combination of the above-mentioned programs. By integrating healthcare for all, the principles of equity, beneficence and justice are validated. By providing individuals with the option to pay for further or more advanced or different healthcare, they are allowing patients to maintain autonomy and act in ways that benefit that individual specifically.
This concept is an ongoing debate within the United States healthcare system that becomes evermore relevant each day as healthcare continues to become increasingly expensive and inaccessible to so many. Unfortunately, the problem is so overwhelmingly large and complex, that a simple solution is not feasible. As a medical student fronting this challenge head-on, I think it is worthy to reflect on the Hippocratic Oath that we all promise to uphold throughout our time as students and physicians; “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
I cannot agree more with the push for physicians and hospitals to be more transparent in the cost of procedures and the ways in which a patient can pay for their healthcare in a way that works best for them. My wife gave birth to our first child just a year before I started medical school and when we were preparing for the hospital stay, we had several friends and family approach us regarding the best way to pay for our child. Little did we know that the OBGYN office we had been going to because they were covered by my insurance were slowly charging us the amount, we would need to pay to cover our deductible by the time our child was born. While this may seem like a good gesture by our physician, in the end we paid more for the clinic visits and the hospital visit through insurance than we would have had we gone paying out of pocket. This almost feels like a breach on my ethical right to autonomy and justice. While we did receive great care and I truly believe the physicians had our best interests at heart, we did not understand the cost of having our baby because no one wants to work with a patient they’d rather see how much money they can get from the insurance and other organizations.
Many individuals continue to push for a social healthcare system within the U.S. and many others push back stating that the cost to the taxpayer would be too much of a burden and not be fair to the population as a whole. While both sides bring up valid arguments, I think Dr. Sammour brings up a really good point of the ideal system being a hybrid. If instead of trying to replicate a system that is already in place, and we try and establish a new norm of being transparent with our costs and being focused on providing quality over quantity we may be able to revolutionize the system into something that actually works. Our society has become so hyper focused on the need to obtain money and status that doctors are often looked at as money hungry individuals who could care less about the health of their patient and more about which watch goes best with their new car. However, because of these few individuals who focus on the quantity over quality of care, those physicians out there who truly work tirelessly to improve healthcare in their communities are overlooked and not given the chance to help implement real change. We need to return to the root reason for healthcare, which is to provide healing to those in need and improving the quality of life within our communities.
He brings up an interesting idea during point three of his plan. That being that we need to prioritize quality over quantity when it comes to life. While I would agree and advocate for myself that I would rather live a shorter life that is of higher quality than a drawn-out life without much mental capacity or contribution to society or others, I imagine this point being manifest in a situation where the hospital is advocating the withdrawal or withholding of care from an elderly person when their family, or themselves, are asking otherwise. It seems that in order to truly pursue this goal, society would have to unanimously agree with the tenant of quality over quantity. And an institutionalized push toward setting that priority could result in the violation of the tenant of "do no harm" that we accept in healthcare or could serve as a threat to the autonomy of a patient to make their own decisions. Please reply and feel free to disagree with me or bring up opposing points, its a tricky issue and I would love to hear other perspectives.
"Tricky" is putting it mildly. ;-)
The patient's autonomy is foremost. Once anyone begins to make others 'death
choice', we begin the journey down a rabbit hole. ( And I exclude those situations
where the patient is incapacitated, requiring next of kin to step in.)
I'm not proffering a solution to the dilemma. But I can definitely say , or should I
defiantly say, Government can never be allowed inside this decision.
I totally agree that creating a system that focuses on prioritizing quality over quantity of life may lead to providers violating non-maleficence, and defining this is extremely complex and not unanimously agreed upon. Non-maleficence or “do no harm” is completely relative to the individual patient preferences. For one patient “do no harm” may mean stopping cancer treatment because it is negatively impacting their quality of life; while for another patent stopping cancer treatment may be believed to be causing harm because it is allowing their cancer to grow and ultimately decrease their quantity of life. This comes back to your point that prioritizing quality over quantity of life may also threaten patient autonomy. Ultimately, it seems patient autonomy is what ends up defining non-maleficence (as well as beneficence).
I believe one issue we run into when “fixing” or creating a healthcare system is that anytime we prioritize one goal, such as quality over quantity, this priority could be argued to violate or threatened ethical principles in some way since we do not unanimously agree what defines these principles. How do we overcome this? I do not have the answer to that. However, I’m not sure prioritizing quality over quantity of life will save the U.S. much money, at least initially. There are vast studies showing adopting healthy lifestyle choices can decease risk for many of the major killers in the U.S. (i.e. Cardiovascular disease, cancer, etc.) But in order for us to equitably and effectively promote this, a large number of resources will need to be provided and accessible: affordable healthy food options, safe environments for physical activity, mental health resources for stress reduction, education for healthcare providers about nutrition, etc., etc., etc. One could even say prioritizing this may cause an issue with justice. While one person may have the resources to prioritize quality over quantity of life through healthy choices, another person may only have access to be doing whatever they can to survive. Again, I don’t know what the answer is and while I agree that most people would choose quality over quantity of life, not everyone has the ability to do so. If we are to switch to this paradigm of quality over quantity, it will not come with no cost and this cost may manifest both financially and with ethical violations.
Healthcare is a matter of life or death. You just need it.
So is food, but i dont have a right to hold up a supermarket
@@devinsgueglia6478 it is your right to access food to eat whenever you are hungry. If food is as expensive as US hospitals everyone will die from hunger. food is not right. But it is your right that supermarket food is not crazy expensive. Same here for healthcare
Fatima Hussain in Europe food and housing is mostly a right, in the U.K. money to buy food and accommodation is supplied to those in need, and local authorities have to supply accommodation to children and vulnerable adults.
I know that the above views are not held in North America, however my experience is the Americans are very generous when they individually see someone in need.
Death is inevitable, how can putting off something that is literally inevitable be regarded as a necessity?
@@costakeith9048 I guess it's only as necessary as we deem it to be. But then again, so is eating food, and sleeping, with your logic. Pretty nihilistic if I'm being honest.
None of the people I know who've been treated in hospitals and got in the mail huge bills ever paid a dime.
The answer: don't pay at all and the system will need to change to a normal one.
Wow, Stanley. You are very clever for coming up with such an easy solution many of us were too shocked to think about. How often do hospitals send bill enforcers after people they did not demand to pay up front? XD
Healthcare is very tough. I don’t think it’s a right, but some may feel I’m selfish because some people suffer from not having the means to get good treatment. I hear for the greater good it should be done by our government. My view is the government is bad with just about everything they do. They will spend that money elsewhere and it will eventually fall apart. I do believe our system in America is horrible right now. He is right we need something in between. A free market type of healthcare. Competition drives down prices. It needs to be more affordable and realistic. I hope this problem in America is resolved. I believe more money will be made for everybody and more people will be receiving quality healthcare with fair prices. More people will not reject a checkup with fair prices. Checkups are essential to keep health cost down. People in the states tend to discover illness too far into its stages. We need a balanced system that invites Americans to tend to their health.
Exactly, poor people should just get better jobs or die. Healthcare definitely isn’t a right. We should spend our tax money blowing up people who live in caves for American Freedom! Why would we invest our tax dollars in our citizens physical and mental health? Poor people deserve what they get! I want my tax money to be spend on 350 million dollar jet planes that rain death and destruction upon the denizens of third world countries!
@@WorldofLos is this sarcastic? lol
"I don’t think it’s a right"
Really? So if a kid is born with a genetic disease, you don't think they have the right to be treated? Are you actually insane?
I have thought about this exact question often. Dr. Sammour does a great job analyzing both sides and finding a common middle ground. The reality is whether healthcare is a right or a luxury is ultimately up to us as a society. As was evidenced in his talk, Dr. Sammour shows that and explicitly socialist or an explicitly capitalistic healthcare system both induce unnecessary financial burden. Now to say a hybrid system is the ideal isn’t necessarily true. We have a hybrid system here in the united states and it has proven to be quite troublesome. Children, the elderly, and the impoverished receive the absolute best healthcare the world has to offer at no cost to them. However, the very doctors that are providing that healthcare are paying 40%+ in taxes to cover our government sponsored programs while also have to pay tens of thousands of dollars per year to cover their own healthcare insurance. Now, doctors make a good amount of money but those in the middle class of the USA who do not qualify for Medicare or Medicaid are left nearly destitute because of the tax burden and healthcare costs. In my opinion, cost transparency would drastically increase the effectiveness of a capitalistic system. It would introduce competition and provide patients with an itemized bill, allowing them to see exactly what they would pay for and giving them the freedom to decide whether or not they can find the same service somewhere else for less money. This would allow the US system to retain its quality while simultaneously increasing accessibility. Another thing to consider, as Dr. Sammour explained, is shifting our ideology regarding death and dying. Humans definitely have an expiry date. Our lives are temporary and rather than focusing on prolonging them, we should focus on making decisions that fill our lives with quality experiences. Afterall, what is life without quality. Shifting our societies focus to quality over quantity will streamline our healthcare as we focus on what really matters as opposed to focusing on what may or may not give us a few more days, or weeks, or years. One of the best books I have had the pleasure of reading is When Breath Becomes Air by Paul Kalinithi. It highlights beautifully that meaning is found not in the number of days that we have but rather by the experiences we choose to fill those days with. A large part of our problems in healthcare and at large reside in our misunderstanding of what matters most. It is not the money we make, the success we attain, or the places we travel that fill our lives with quality. It is the relationships we build and the people we serve that ultimately help us find fulfillment and count our lives as ones of quality. I am anxious to hear others opinions regarding this topic. What are your thoughts on how we can improve healthcare worldwide and make it simultaneously more accessible and more affordable?
I want to counterpoint your statement that healthcare will reach a point that no one can afford it.
Healthcare would go out of business if it reached that point. The necessity is for government to get out of the way with its regulations and subsidies and allow competition to work.
The drug companies and hospitals will charge you whatever they want! The gov doesnt regulate the businesses anymore and just let them do whatever they want!
Also it's TRUE in capitalism like in nature when a species gets to populated or powerful there prey begin to die and then they themselves die and the process reatarts..that's called a recession..accept after the recession its business as usual not a total top to bottom Destruction
@@jackschwanke603 LOL that doesn't happen in ANY industry. Does Apple charge 1 million dollars for an iphone? No, in fact 96% of Americans have cell phones because of competition.
I believe healthcare is a fundamental human right and should be available to every, regardless of their ability to pay. The provision of healthcare is essential for maintaining the health and well-being of individuals, and it should not be considered a luxury that is only available to those who can afford it.
The argument that healthcare is a luxury is based on the idea that it is an optional service, that caring for your fellow man is not a humanitarian obligation shared by us all. This perspective also fails to recognize the crucial role that healthcare plays in promoting social and economic development. Healthy individuals are much more productive and better able to contribute to society. When individuals are sick, they are unable to contribute to society, and the duration of such unproductive periods are substantially prolonged when healthcare is unavailable.
Furthermore, healthcare is a basic human right that is recognized by the United Nations. In 1948, the UN General Assembly adopted the Universal Declaration of Human Rights, which stated that "everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care." This declaration is a testament to the importance of healthcare as a fundamental human right that should be available to all individuals.
Moreover, the lack of access to healthcare disproportionately affects marginalized populations, including low-income individuals, racial and ethnic minorities, and people living in rural areas. These individuals are often faced with significant barriers to healthcare, including lack of transportation, discrimination, language barriers-all of which may lead to poorer health outcomes.
In addition, the provision of healthcare is a moral imperative that reflects a society's values and priorities. A society that prioritizes healthcare as a fundamental right demonstrates its commitment to the well-being of all its citizens. On the other hand, a society that views healthcare as a luxury reflects a mindset that values profits over people's lives and well-being.
Excellently stated! I wholeheartedly agree, but couldn’t have put it this well 👍🏻
From each, according to his ability; to each, according to his need.
How do we fix this system in America? I also grew up in a country that had socialized medicine, and moved to America and have experienced the differences of health care from my family back home in Slovakia and how medicine is here. As Dr. Sammour mentioned, we have some of the best medical care in the world with unlimited resources, yet for every patient is treated, “another would get rejected.” As physicians, how do we choose who gets the care and who doesn’t? His colleague mentioning how you have to choose either high quality health care for some, or you have to expect rationing, because it is simply too expensive. Unfortunately, the reality of our world is that this is true, we either have expensive health care for some who can afford it, or we have poorer health care for all. Can we somehow meet in the middle for this? Three tier system is important: public health expenditure on health care needs to be balanced in private and public well-funded health care model. What will it take to be able to figure out having a balance in both? The question should be are we as a society willing to make the right choices so that we can continue to achieve those goals, or are we going to stand by and watch, as our rights AND our luxuries become more and more inaccessible to us.
I agree with your comment. I think that it is very important that we are able to meet in the middle with this. Everyone has the right to healthcare, and the system should be made to care for everyone, not just a selective group of people. I think your perspective is very refreshing as you have experienced both types of medical care. By caring for all we are making sure we consider ethics in our decision making, and not excluding anyone just because of the money that they have or don't have.
A model that currently has high approval and satisfaction rate of at least 80% for example is Taiwan's National Health model, Google/look it up, one of world's best. It's not perfect (nothing short of utopian is), but it's one of the best (if not the best) I've seen so far. Very wide coverage, including preventive and dental care, modest co-pays, highly efficient, comprehensive, competent, and fast healthcare. Very low administrative cost, tax that fund it is modest, sets limit of maximum out of pocket per year. What would make it even closer to perfect is if it's not universally compulsory, despite relative small negligible tax expense, (for those who object out of principle), BUT with the caveat that only those who voluntarily choose to contribute in with their salary tax money to the system would benefit from it.
Healthcare is like food. It is neither a right, nor a luxury.
Food is a necessity, but due to the fact that you don't have to pay much for enough food to survive, then it isnt a right. But healthcare is expensive and if you can't pay it, you die. Therefore it should be a right.
So the military is a right ? Help me understand your logic...
@@funkyflights When did I say that?
silence .... You said healthcare is neither a right or a luxury .... So does that also apply to the military ? Because I’m taxed like crazy for it ... Is that my right or a luxury ?
@@funkyflights military is not a right..but self defence is a right.
Also, nations cannot exist and be sovereign withought forms of defence.
Despite being one of the wealthiest countries in the world, the US healthcare system faces many economic challenges that significantly impact the quality and availability of care. These issues raise significant ethical concerns regarding justice in healthcare. Specifically, equal access to healthcare, where the US healthcare system falls short. This is in part because millions of Americans do not have health insurance and in part because of the unbelievably high cost of care. Combined together, this creates significant disparities within different socioeconomic layers. Further, the high cost of healthcare leads to financial burdens and underutilization of medical services. According to a survey conducted by the Commonwealth Fund, around 37% of American adults reported either not going to the doctor, not filling a prescription, or skipping a recommended medical test or treatment in 2020 due to cost concerns. Additionally, around 23% of adults with health insurance reported having trouble paying their medical bills. A related issue with healthcare economics in the US is the impact of high costs on public services which limits the resources available for their initiatives. The best example being that the CDC's budget has been cut by around 10% since 2010, after adjusting for inflation according to NPR. Justice in healthcare requires that individuals have access to necessary medical care regardless of their ability to pay. The US healthcare system fails to meet this standard and denies many patients from one of the most basic rights. Another aspect of justice where the US healthcare fails is the equitable distribution of resources. For example, according to a report by the National Alliance on Mental Illness (NAMI), racial and ethnic minorities in the US are less likely to have access to mental health services than their white counterparts. The report cites a study that found that only 8.7% of African Americans and 6.8% of Hispanic Americans used mental health services in 2015, compared to 16.8% of non-Hispanic white Americans. These disparities are often directly related to social and economic factors, such as income and education level. As healthcare professionals and policymakers, it is essential that we prioritize justice in healthcare and work towards creating a healthcare system that is accessible, equitable, and accountable to the needs of all individuals.
I don't understand, I'm paying like 7,000 a year for health insurance in the U.S., when added to state/federal taxes, it's basically like 30% of my income, how is that different to Europe where people usually pay 30-50% taxes and have free healthcare and education also. It seems basically the same, but in the U.S. you'll have to pay a lot more because of college and the additional fees for healthcare, because even if you have healthcare insurance, it'll only pay maybe 70% of the bill I believe?
It is fair to share the cost of your healthcare with your fellow citizen because getting sick or injured is (partly) involuntary, unavoidable and happens at random. You also can not negotiate not to get it like a new car because you will die without it. Patient is not same as customer because customer can refuse to buy. This is why getting healthcare should not destroy your finances. All-privatized healthcare creates unnecessary personal tragedies which universal system could mitigate.
I disagree with this statement since its not true "All-privatized healthcare creates unnecessary personal tragedies which universal system could mitigate." There is nothing unique to privatized healthcare that creates tragedies since govt healthcare creates many tragedies as well. Every govt healthcare system in the world creates personal tragedies everyday.
European Health System
An Explaination and Its simple.
If we compare the EU to the USA structure in terms of cost to GDP, Europe average 11% of GDP to the USA 20% of GDP, (2019) with the EU at 99% coverage and with improved life expectancy rate, compared to the USA.
In America USA, the health system is profit run for the most part and privately handled. Patient care is secondary to profit for 50% of coverage.
The EU system is state run, and covers everyone, from birth to death and costs half of the USA system. And USA life expectancy is 42th in the world on the world ratings.
Therefore a % of the health cost is based on profit to be paid out in dividends.
Additionallly not all people in the USA are covered, (approximately 15%)
Its a Bum deal for Americans. It costs 8-9% of GDP more than Europe.
WHATS IN IT FOR THE EU PATIENT
If you pay taxes, and contribute to the central government POT, you are covered for all treatment, hospital costs, surgery, drugs, implants, chemo, post op therapies, cost of prescribed drugs, specialist and normal GP doctors bills, specialist bills etc etc. (There are some small exceptions.)
Its all included.
The system is rated as better than the American system as nobody is excluded and the system covers 99% of all patient needs
THE EUROPEAN SYSTEM HOW IT WORKS:
All european health systems are government run and are simple systems .
It is a central, run by the govenment covering all healthcare needs for the population and is non profit , universal, and also internationally recognised between all EU countries.
The EU underlying system is through fiscal residency of a person, (ie you pay into the employment tax system of the country you live and into health system )
Simply each person pays into the THE GOVENMENT POT as a % of individual pay packet contributions where you are employed. As a registered unemployed, you are covered. Importantly even if you are unemployed.
Importantly you are still covered. you as a patient get equal rights and coverage across Europe.
The state (country) is the employer of all health staff, doctors, nurses, etc.
Central government then covers the hospitals costs through a system which keeps the hospitals covered for the expenses of each patient.
HOW IT IS MANAGED:
Central Government in each country collects the money through the taxes you pay as a citizen, and redistributes it (generally) to regions ,hospitals, and doctors etc which then distributes the funds to the health system used by the patient.
The Government also allows the private sector to operate under the public system, to build hospitals, run them privately. Each country allows this in different rules, like Germany/UK/France etc. They are then licence to operate by the government.
But importantly, the patient who pays to the state contributions through his salary, has equal rights to access all hospitals.
10% of the EU health system is private. IE If you wish to pay an additional supplement, you are allowed to do this into to the private scheme on top of your mandatory state payments so you get private health care coverage. But you cannot opt out of the central system.
Most of people dont have the means or desire to pay private insurance policies.
WHATS THE BENEFIT
Basically theEU system covers 99% of people and costs the half of the USA system. In addition to this, with the EU system, if you pay contributions to the health system in the UK or France, you can have full medical care in Germany, Italy, Hungary or any other of the 27 states.
If you lose your job, you will still be covered. you just pay less to the system as unemployment reimbusement to you is less, you pay less, but the more you earn at work, the more you contribute to the central system. Its based on % of earnings.
These European systems are based on the old and original UK system, The National Health Service, abbreviated to NHS, was launched by the then Minister of Health in Attlee's post-war government, Aneurin Bevan, at the Park Hospital in Manchester. Aneurin Bevan, Minister of Health, on the first day of the National Health Service, 5 July 1948 at Park Hospital, Davyhulme, near Manchester.
THE REAL ISSUE
1. EU Health is non political, non profit, more efficient and cheaper that the USA system,
2. BETTER in many ways, as the patient is first, and health has no “profit COST”.
3. It reduces the cost on the Government. (11% against the USA 20% per year GDP)
4. Its not fragmented. Its coverage is national, and for all.
5. If you are REGISTERED as a TAX payer, you have no problems.
6. If you are clandestine, then you get some emergency humanitarian services only.
Thus the authorities know who you are and send you home after.
Thank you for breaking it down
I didn’t read your whole comment but life expectancy doesn’t accurately measure quality of healthcare between the US and the EU. There are way to many variables involved there. For example, one reason the US has a lower life expectancy rate is because of a abnormally high rate of degenerative diseases in the population such as diabetes and obesity. These things are not as common in the EU do to of course, differing diets in the two places. Just wanted to point that out. Life expectancy isn’t always a direct inductor of the quality of healthcare.
I agree healthcare in the US sucks, but I don’t think it’s because it’s not universal like the EU. It’s because of corruption in the medical field. You can walk in the doctor’s office and be charged $4,000 for a x-ray or $200 another. It’s a total mess.
@@nunyabailey Correct, but WHO, (Primarily funded by the USA) does not limit quality of healthcare to only life expectancy. There are many other factors which are taken into account. Including diabetes and obesity treatment.
@@scott7008 that wasn’t what I was saying.
I would say health not healthcare should be our target and health is always earned in one form or another. If the cost of healthcare and the problems of cancer, diabetes and Alzheimer's continue to escalate then a free healthcare system may become a mirage.
Healthcare is a necessity.
It a right as long as we value human life more then money but I am aganst Solisum it a right but it could be cheper and better qulty over all.
I understand that it is possible to give a patient with knowledge of life quality in the even of a treatment decision. --- But how do you even ask or relate to a patient this concept? especially how do you know if you are already hurting a hurt terminally ill patient? The state of mind of the family, provided it is not their volunteer choice.
After all "quality of life" is important as well the "quantity"
And I am not sure if this is our first priority talking about "quantity" of life out of all the problems we have in our health care system.
1. We have highest mortality rate on preventable diseases
2. We are high on hip replacements, knee replacements, because payer rate is high on these procedures.
3. We have low preventive care for medicare patients readily available since the fee-schedule is low, whereas more hospitalization since it is paid high by Medicare
4. We have volume-based payment, instead of value based payment model
5. Is our health care system Patient - Centric?
There are more.. to address, before trying to reduce quantity of life on terminally ill patients.
Healthcare is a commodity. Because someone has to offer you the services. You can't force a doctor to heal you. It's supply and demand. Now, the most interesting hard question I've asked my economics students is is there a cost value to a human life? How much is a human life worth or are all human lives really worth the same?
"Food is a commodity. Because someone has to offer you the services. You can't force a farmer to feed you. It's supply and demand. Now the most th interesting question I asked my economics students is is there a cost to human life? How much is a human life worth or are all human lives really worth the same."
@@billyaepicgamer8642 That's correct. Food is a commodity just like healthcare. Nobody has ever answered me how much is a cost of human life. Because understandably it's a hard question to answer. But truth is there is a cost.
@@cloo7525 Actuaries put a price tag on the value of human life all the time, last I checked about $130k/year of quality life was the average value given in the US. Though, of course, given more specifics about an individual, that number can be refined further and change dramatically.