While I was in nursing school we were trained under the idea of social justice and that access to healthcare is a universal human right. Now as an experienced RN who has worked with both the well off patients and patients from very low socioeconomic situations I think I understand the issue better. Turning philosphy into policy and practice is an entirely another issue, but one that should be informed of this universal truth. The worth of any society is not based on how fabulous the wealthy and priviledged are, but on how well that society takes care of its most vulnerable members. Ideally our society should be perceived through the lens of how good our schools are, how healthy and happy our children are, how well we take care of our elders, how well we empower disabled individuals to reach their fullest potential and not on the consumeristic Real Housewives of Atlanta/ BH/ NYC and how much our CEOs are getting paid.
Take education for example. Our founding forefathers believed that in order for a democracy (pseudo democracy/ republic) to work, each member of the democracy has to have a minimum education in order to understand the issues and be informed voters. Here in lies "free" education for our children in the US. (The quality issues and ensuing debate could take up warehouse full of servers).
Even from a capitolistic free market perspective it makes sense that healthcare is a social justice issue and should be a right and not a privelege. More and more employers
are recognizing that by investing in preventative healthcare for their employees and offering discounts for health improvement behaviors, they see improved productivity, reduced absenteeism, and greater loyalty.
I disagree with the notion that because something "costs" something that it is a priveledge. The logic is faulty because everything "costs" something. The US legal system is very costly but everyone has a right to due process. Who pays for public defenders? Who pays the judges? Who builds the court houses? Who pays the law enforcement officers and the lawmakers? It costs a lot of money to prosecute an individual, even to write up a parking ticket, but you have a right to appeal that parking ticket and you have a right to an attorney in criminal cases. As far as our "free"education system, you home owners in some school districts know precisely who is footing the bill, even if you don't have any children.
Safe drinking water costs a lot of money, but it is a right. If your child developed cancer because she drank contaminated water, in the US you would have the right to engage in litigation to preserve your child's right to safe drinking water. Sure it costs money and all of us pay for the drinking water through our rent, our taxes, our water bills, but if someone needed drinking water and was on the brink of dehydration failure to provide drinking water would probably land you in jail even if that person did not have the ability to pay.
Just to complicate the issue. Medicare is a program designed to provide healthcare coverage for older adults. If there was a 80 year old man who was worth over 10 million dollars, should he be denied MEDICARE because he CAN afford to pay? Shouldn't we just bill him at the market rate and expect him to pay for his CABG and extensive rehab in a SNF out of pocket. Or does he have a right to Medicare?
This is a wonderful topic and I thank the OP for presenting it. I especially appreciate the input from the NHS nurses. Just as an aside, would you alter the quality of your care for your patients based on their ability to pay and your perception of their right to healthcare?