Is Healthcare a Right?

¶ … Along the way, scholarly resources such as books, peer-reviewed journal articles and reputable websites will be used to create or support the opinions or answers given. The three questions that will be answered will include what basic types of healthcare everyone should have access to and why, a choice from thirteen risk factors that impact infectious disease and a recitation of how nurses can play a part in one or more of the millennium development goals (MDG) set forth for global health.

While being too loose and generous with what people are entitled to and/or the depth and breadth of what nurses can truly do is a danger, to suggest that neither is worthy of consideration would be less than wise to assert as true. Healthcare as a Right The first essay question asks what types and forms of healthcare should be a given and a right to everyone regardless of race, gender, class or background.

Before answering this question, there are a number of wrinkles and so forth that have to be taken seriously. First, the healthcare of many countries is in tatters due to ingrained corruption from the government or ingrained bad habits of the people. For example, two thirds of Nigerians drink while working and that is appalling not to mention dangerous and unhealthy on a number of levels. This is an example, albeit extreme, of people that are really causing their own problems and/or a government is doing the problem creating.

Of course, dictators and despots like Kim Jong Un (along with his predecessor Kim Jong Il) and Mugabe are more concerned about their own health and well-being than those of the people. Even ostensibly better-off countries India and much of the Middle East are torn apart by things like filthy drinking water and lack of proper sanitation infrastructure such as working toilets and the like (Heinjnen, Rosa, Fuller, Eisenberg & Clasen, 2014). Another wrinkle already touched on is human behavior leading to health maladies.

Indeed, to suggest that this is something foreign to civilized and developed countries like the United States would simply not be true. A good number of the diseases that ravage those in the United States are induced by poor behavior and life choices and it is usually something that happens over years or decades rather than a few days or months.

However, the problem is aggravated by a system and a framework where less healthy foods are much more ubiquitous and much cheaper and the education of those that are vulnerable is hit or miss if it exists at all. Even when it does exist, parents and other caretakers are unwilling to take care of themselves, let alone others. However, genetics plays a part as well and some people get sick even with some strong efforts (Collins, Ryan & Truby, 2014).

The deck is further stacked against the poor and the disadvantaged in the form of a healthcare system that becomes more expensive by the day in terms of what it takes to pay for items out of pocket and/or the healthcare insurance premiums that have to be paid to mitigate or limit those costs.

While the number of people uninsured in the United States is in the stark minority, it still numbers in the millions of people and the number of bankruptcies and other financial strife (or even death) that is caused in whole or in part by lack of access to money and/or healthcare is quite embarrassing (Zhou, Remsburg, Caufield & Itote, 2012).

However, those that would say that the United States and other non-socialized medicine countries should just "spend the money" have to recognize that transfer payments are already a huge part of the United States federal budget and that number will get much bigger even if no upgrades are made to the social and medical safety nets.

Social Security, Medicare and Medicaid alone are more than half of that standard budget and the swelling amount of people reaching or already at retirement age is going to make things worse monetarily (Gamkhar & Pickerill, 2011). With that all being said, there should be a minimum standard of care that all people should have the right to access for little to no cost. Indeed, people with healthcare plans are generally able to get preventative care and screenings such as physicals and checkups included at no additional cost to the patient.

Such care should be low-cost or subsidized (if not both) for all that cannot afford to do so because of limited funds and/or no insurance. There should also be a heavy push to educate people how to roll back disorders or prevent them in the first place as this has led to great gains in the fight against obesity in many corners of society.

After all, addressing only the sick people is a reactionary step rather than a prevention-related one and the latter will yield much better results over time (Schimmel, 2013). For this all to work and for all the cards to be on the table, it should be said that basic and necessary care can and should be provided via whatever means necessary without bankrupting the state or its people.

However, the patients and people of these areas have their own burden to meet and it is not as simple as the government just shutting up and giving out the care. Indeed, any government program is funded by taxpayers as government does not magically get that funds by themselves and most of the people getting that money are not paying taxes to begin with, or at least not as much. The point is that there are ethics for both sides, that being the patient and the government/people.

The patient has a right to get access to low-cost and quality care but they also bear a burden to not live in a way that is self-destructive. For example, while the Affordable Care Act did away with waiting periods for pre-existing conditions, a lot of the reason for that (although some people got unfairly hurt) was because people would skip out on being insured even though they could afford the premium but they signed up only when they really needed it.

That is akin to buying a homeowner's insurance policy when one's house is already burning down. It is not fair to the other people who pay their premiums when they are not in need of a payback because that is how the system works…the non-sick people should be there to offset those that are sick. The government and the people have to work together and the former should not be enabling the preventable actions of the latter.

Withholding care is not what is being suggested but rather accountability and knowledge (Schimmel, 2013). Infectious Disease Factors If there is one factor or confluence of factors that stands out as it relates to infectious disease, it would be cleanliness and sanitation. As noted in the prior section, there are many parts of the world where running water, working toilets and other basic sanitation needs are paltry to completely missing. This leads to easier spreading of disease as well as bad teeth/gums and so forth.

The terrible part about all of that is that the people affected by this happenstance are essentially unable to prevent this from being the case as the governments in question are unwilling or unable to do anything about it. However, even civilized countries like the United States and China have issues relating to sanitation and cleanliness as a function of how it causes disease (Carlton, Liang, McDowell, Huazhong, Wei & Remais, 2012). Even national sports teams are having issues.

The Tampa Bay Buccaneer franchise had a major problem with several people getting drug-resistant staph infections (MRSA) even though one would assume that the doctors and other personnel for the team would have access to all of the money and resources to treat patients effectively and to sanitize treatment areas and tools. However, three players by the name of Carl Nicks, Lawrence Tynes and Johnathan Banks all contracted some form of staph in a matter of two to three months (Volin, 2013).

What this means in the grand scheme of things is that many countries and employers are unwilling or unable to stop infectious disease spread through cleanliness and sterilization while others are simply inept and not paying enough attention to detail. When it comes to the poorer countries, they should get assistance from the United Nations and other organizations to upgrade and fix their infrastructure.

Rather than giving the despots and corrupt a pile of cash that can just be frittered away, the upgrading and repair of these systems should be done under heavy supervision and extensive training should be given to the domestic healthcare personnel and sanitation workers in those areas so as to create a new standard that keeps the entire community healthier (Clasen, Pruss-Ustun, Mathers, Cumming, Cairncross & Colford, 2014). However, even domestic healthcare minds and people should drill sterilization and cleanliness into the minds of people every day.

This is not to say that people should bathe themselves in Purell and be unwilling to touch anyone or anything. However, people that go against the grain in terms of keeping clean and preventing disease should be called out on it. People shouldn't be embarrassed or impugned but they need to be dealt with when the need arises. For example, there is the story of the Muslim woman that did not prefer to engage in the normal scrub-down procedure due to her religious beliefs.

While her beliefs should be honored and respected ninety-nine percent of the time, this is absolutely one of those "one percent moments." If she is unwilling to proper sterilize herself before entering an operating room, she should not be practicing medicine. That being said, standards should always be assessed and checked to make sure they are reasonable and ethical. However, anything that compromises patient safety and that can be reasonably prevented should be shut down immediately.

Just policing the people that go obviously rogue like nurses that steal pain patches and injections and so forth is not enough. Best practices are best practices and they should be followed to the letter without fail every time and with no exception (Clasen, Pruss-Ustun, Mathers, Cumming, Cairncross & Colford, 2014). Actions can be taken with the general public.

There is no need to be as aggressive as with a medical setting but that is to be expected given the margin for error in regular life as compared to when someone is mid-surgery. Even so, there are tactics and habits that all people should be engaging in every day including taking a shower, washing one's hands after using the bathroom, not taking any personal items (especially food) into a bathroom for any reason and so forth.

These are, of course, little things but they certainly add up over time and getting away from things that can easily spread disease is a major part of that. Another major part is politely but firmly shutting down the kooks that think that immunizations are dangerous or cause autism as there is no proof of this and the obvious greater good, even with the risks that are known and admitted, is that people should get immunized for measles, mumps, rubella, tetanus, whooping cough and so forth.

Were it not for absent-minded and ill-informed people like those that demagogue immunizations, the measles outbreaks that have been happening in the last few years would not be occurring. At this rate, polio may rear its ugly head again (Clasen, Pruss-Ustun, Mathers, Cumming, Cairncross & Colford, 2014). Millennium Development Goals The Millennium Development Goals, as laid forth by the United Nations on the projects website, were created and designed in 2000 at the Millennium Summit.

Those goals are as follow: Eradicate Extreme Hunger & Poverty Achieve Universal Primary Education Promote Gender Equality & Empower Women Reduce Child Mortality Improve Maternal Health Combat HIV / AIDS, Malaria and other diseases Ensure Environmental Sustainability Develop a Global Partnership for Development (UNMP, 2015). In terms of how a nurse can personal contribute to one or more of the above, the answers to this are quite obvious for most of them. However, there are some limitations.

The spread of malaria and HIV / AIDS (the third to last goal) is really not something that can be controlled except through influencing and educating people about what behaviors and practices to avoid, and that applies more to HIV / AIDS than malaria. Malaria is the biggest killer of all time in terms of disease (and it is not even close) and the things a nurse does will probably not change that.

Until disease-laden mosquitos and sanitation around the world is brought up to a much higher standard, malaria is here to stay and it has been this way for decades ("Malaria the Biggest Killer," 1979). For similar reasons, the development of a global partnership, elimination of hunger and poverty and achievement of universal primary education are also things that a nurse cannot do or is not involved in, if not both.

Nurses can help promote gender equality for women by treating men and women in the same manner even when governments and other medical professionals do not. Given that most nurses are women, this would all the more easier to pull off because it would be less than a hard sell to justify this to a nurse that is well aware and cognizant of how men and women are treated differently both in civilized countries and ones that are oppressed or at least developing.

However, believe it or not, there are some viewpoints being pushed that point to a masculine centering of nursing or one that is not gender-specific. The latter of those would be optimal so long as there is equal care given for both men and women, specific to their gender-specific needs of course (Hollup, 2014). Child mortality is a mixed bag because many of the factors that lead to higher child mortality are outside, if not well outside, of the scope of what a nurse can do.

However, delivering prompt and adept care to mothers and children in medical settings of any sort can lead to less children dying due to disease or other medical maladies. One way to drive down the child mortality rate as it relates to nursing care is to measure and review the scores and performance of nurses in pediatric situations. Two such yardsticks that are used are the Nursing Manpower Use Score (NEMS) and the Therapeutic Intervention Scoring System (TISS-28).

These measures are used in pediatric intensive care units (PICU's) and can be applied to just about any hospital situation where a PICU exists. One such study did this sort of review in the Country of Brazil and the two different testing methods showed strong correlations between the two for the same situations. This was verified by using both metrics at the same time over a period of two years, more than eight hundred patients and during almost eight thousand events for those patients (Travi-Canabarro, Stochero-Velozo, Rosaria-Eidt, Pedro-Piva & Ramos-Garcia, 2013).

Maternal health, another of the Millennium Development Goals, is much the same as child mortality and they are obviously related in that a healthy mother often leads to a healthy baby. The last goal that has not been mentioned yet outside of the initial list would be ensuring environmental sustainability. While this is on the edge of being outside of the nurse's capability to be involved in, they certainly have a way to contribute to a solution even if a regimented system is in place.

This means disposing of needles and other sharps properly, recycling and reusing when ethical and reasonable, properly discarding of items when that should never be the case (e.g. needles, etc.) and so forth. For any sustainability system that is in place, nurses have to be involved as they are going to be doing the busywork that physicians are not going to have time to do (and will probably be unwilling to do given their rank as compared to the other medical professionals) and so forth.

Situations where sustainability and nursing should always and obviously intersect is in the case of nationalized and socialized healthcare system. Of course, the resources and money involved is finite (and often dwindling) in nature and this means that resources should be.