Who is my neighbor? A communitarian analysis of access to health care for immigrants

• Published in: Theoretical medicine and bioethics Vol. 32; no. 5; pp. 327 - 336
• Main Author: Kuczewski, Mark G.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-10-2011; Springer Nature B.V
• Subjects: Delivery of Health Care - economics; Delivery of Health Care - ethics; Education; Emigrants and Immigrants; Ethics; General Surgery; Health care access; Health care policy; Health insurance; Health Services Accessibility - economics; Health Services Accessibility - ethics; Health Services Accessibility - legislation & jurisprudence; Health Services Accessibility - standards; Health Services Accessibility - trends; Health Services Needs and Demand - economics; Health Services Needs and Demand - ethics; History of Medicine; Human Rights; Humans; Immigrants; Insurance, Health - economics; Insurance, Health - ethics; Patient Protection and Affordable Care Act; Patient Rights; Philosophy; Philosophy of Medicine; Social Justice; Social Responsibility; Theory of Medicine/Bioethics; United States; United States; Amitai Etzioni; Justice; Affordable care act; Michael Walzer; EMTALA; Immigration; Care; Communitarian; Medical ethics
• ISSN: 1386-7415; 1573-1200; 1573-0980
• DOI: 10.1007/s11017-011-9195-8

Immigrants lacking health insurance access the health care system through the emergency departments of non-profit hospitals. Because these persons lack health insurance, continued care can pose challenges to those institutions. I analyze the values of our health care institutions, utilizing a Walzerian approach that describes its appropriate sphere of justice. This particular sphere is dominated by a caring response to need. I suggest that the logic of this sphere would be best preserved by providing increased access to health insurance to this population. This access would marry the rights of these members of our community to access care to our responsibility to contribute to financing of the system. I close with some considerations on what it means to be a member of the community.