Hierarchies of health care: who deserves what?

There’s an interesting conversation going on over at Feministe, where Holly’s posted about various aspects of health care: universal health care and the lack thereof in this country; the very limited state-provided health care that does exist in this country, specifically for prisoners, foster children, and other “wards of the state;” and trans health care and the constant uphill battles for access and coverage free of societal prejudice. Both Holly’s posts and the ensuing comments elucidate the wide range of responses that people have to these topics, especially when they’re all mixed together into one big messy dilemma.

Some people wonder why convicted criminals should have access to free health care far and beyond what’s available to most people on the outside of the bars; here, I find it necessary to point out that, of course, due to our royally screwed up (in)justice system, it’s not just criminals behind the bars and upstanding citizens outside of them, this being just one of the many arguments against making access to health care a merit-based system. Other folks question whether trans health care is really a necessity; in the face of countless trans people and medical professionals who maintain that, yes, trans health care in its various forms is medically necessary for some people, this is simply another form of meritocracy, with trans people’s needs falling rather to the wayside, being deemed less important than – what – “normal” health needs? Still others take the “divide and conquer tack”, asserting that by advocating for the inclusion of trans health care in universal health care, we’re providing conservatives with ammunition that can take down the whole damned cause. Funny, this sounds familiar: hasn’t social movement after social movement tried to shunt their less popular members and issues out of sight, asking them to take the back seat so as to not prevent the more publicly palatable people and issues from getting a pass from the establishment?

I found one point that was made in the course of the commenting to be particularly interesting and something I haven’t considered before: even if we did end up with universal health care, who’d have the power to decide what would be covered and what couldn’t? Individual patients and their doctors? The larger medical establishment? Or, heaven forfend, the government? With the latter especially, what kind of frightening roles will religiosity, moralizing, and prejudice take in deciding who and what are worthy, and who and what are not?

Holly ties up her entry quite well here: “If you accept that trans health care is neither experimental nor unnecessary, and a doctor has prescribed it to a patient, then you have to provide it to those patients who the state has an obligation to provide health care for.” And, it would follow, in the push for universal health care, no medically sanctioned health care should be pushed to the wayside, whether out of misunderstanding or prejudice or some sort of subjective “morality.” Universal health care should be just that: universal, for all people, regardless of where they and their needs fall on some sort of hierarchy of normalcy and necessity that conveniently places the needs of the people in power right up top.

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