To get the ball rolling (take any inhibitions out that you might have):

I believe, A target that is difficult to achieve could be achieved, even though after many years, or life times. However any difficult answer need be thought of outside the square by people like us who have collective knowledge of seeing it through PhiloScie (philosophy and science). Share it and will try reach a consensus. Universal health one such topic. Please express and share your feelings and scientific knowledge for this universal cause when time permits.

Dear Suresh,

I agree that health care access should be universal in the meaning that everybody should have equal access to high quality care regardless of wealth or income. This is the situation in most European countries like UK, France, Germany, Italy, Canada, Spain, Nordic countries, Benelux, Ukraine, Belarus, Slovenia, Switzerland, Austria, Chile, Australia, Thailand, Mongolia, Japan, Venezuela, Cuba. See wikimap of countries with universal coverage http://upload.wikimedia.org/wikipedia/commons/2/25/Universal_health_care.svg

In the US there is health care access for emergencies for everyone but even after Obamacare there will be uninsured people.

I do not agree that health care, except for emergencies, should be available at any time since many symptoms are not signs of disease and overdiagnosis and overtreatment is a real problem in today's medicine with prescribed drugs being a major cause of death in the western world.

Universal access to high quality health services should be the long term target of any health system.

Achieving this goal is elusive as "high quality" is a shifting objective with increasing cost.

As life expectancy grows, marginal costs attached to it grow exponentially. Say you need 100/usd per capita to achieve 55-60 years life expectancy, 500-900 USD/capita to achieve 70 years life expectancy, and 3.500-4.500USD/capita to get beyond 75 years. This may differ in different countries based on habits and culture, food, stress, and other factors, but the ratio is quite similar. At this rate, further improvement in health services outgrow GDP/Capita, meaning that the economy cannot finance the health services improvement anymore.

While science evolves, it may change the rules, but i estimate that breakthroughs required to increase life expectancy like vaccines and antibiotics did, are unlikely to happen in the near future. High-tech medicine attached to high-quality services is very expensive, and the cost of the services are much higher than average income. This makes universal access to top health services unsustainable.

Who knows, maybe science will provide us with much more efficient ways to treat diseases, maybe using nanobots implants, or some sorts of programmed microorganism to keep us healthy and young forever, or going even deeper at energy level, manage the very basic physics at sub-atomic level, reprogram/repair the genetic code. But that's science fiction today, and it will take a wile to happen.

I am late to this party.

Since I believe that optimal health care is good quality food stuff, clean water and clear air, acupuncture, massage, tai chi, tui na, access to Chinese herbal formulas, and a warm puppy... well, except for the clean water and clean air, same day quality health care might be achievable. I think a larger problem is what a population (US population, New Zealand population, inner city population, rural population) PERCEIVES as quality health care... and I would suggest that populations differ in that perception. Unfortunately, if you give the patient acupuncture when they are sure they need chemotherapy, it might be difficult to satisfy their anxiety. Of course, the warm puppy might help with that. So would meaningful education as to what constitutes optimal health and how to achieve and maintain it. If a general consensus as to what is good health and what integrative health care methods are available for its promotion could be arrived at, then deciding upon what methods are necessary to provide same day quality health care might be more realizable.

Thanx Jeannette for your comprehensive assessment. I am sure the following definition of health would get well supported by you:

"Health is a state of mind, body and relationships perceived by an individual, a group, or a community for self at a particular time, space and context .... "

I see this as an utopian thought and could we ever realise this universal state of health for all, seems to be a dream in spite of many of us working towards it's achievement.

Health is a state of mind, body and relationships perceived by an individual, a group, or a community for self at a particular time, space and context ....

Yes. Exactly. Thank you!

Recently, I moved from a middle class neighborhood on Chicago's north side to a greater crime incidence (by 400%), less affluent neighborhood on Chicago's south side. It is always a wonder for me to hear how different people define what they believe to be optimal health. The only consistency is that everyone wants to be of good health, whatever that may be. I think the most hopeful aspect of the utopian search for good health for all is that I believe most everyone nowadays values good health more than affluence or money. This is a real step in the right direction!

The health care for the body is optimum in Belgium, as Hans Olav said there is even an overtreatment, at the other hand, Belgians take too much anti-depressive pills and sleeping pills which indicate that the mind is not in such a very good state of health.

Our society develops too quickly, one generation has no idea anymore what the previous did. So the common pool of memory is disturbed. This gap will become wider in the future I think and which medicine will help, I don't know.

The health of relationships is another question. For myself I have find it with all my passion as well in the family, in art as in science. But now the confrontation between the religions is coming closer and it is not easy to bring them together. Also the migrations as the consequence of political provocation and war is not an indication for a good relationship. 

If the relations are in good health, the body and the mind will share it and there will be happiness.

Dear Rita

Thank you for your enlightening input. Certainly provision of universal healthcare without any barriers to its access will not make all people healthier. More masses would become somewhat healthier, however.

The reasons for your concern re increasing mental and social ill health can easily be focused down to monitory system of economics (refer: utube Zeitgeist addenddum movie). This system breeds necessity on one hand, and greed on the other. Both these lead us into caring for self and self only. One gets left alone when family and social need of belonging and emotionally caring for each other arises in life. Such situations cause mental and social ill health. Some of us go in to depression, others into anxiety, etc., many others resort to abnormal social behavior, some will kill and others will commit suicide.

Somehow this monitory system of economy has to be replaced by resource based economy where money would have no value and remain no motivation for future generations. This I am sure would take care of most ills of the society.

Thank you once again

Regards

hi

http://upload.wikimedia.org/wikipedia/commons/2/25/Universal_health_care.svg

Thank you Mohamad

Regards

Suresh

Similar to Jeanette, I think the main stumbling block is the perception of what people construe as firstly, their 'entitlement', & secondly, a 'quality' service. With a restaurant, if you can provide a reasonable menu & cook well at a fair price, then people will give their patronage. The problem with health care is that we want too big a choice of dishes & five star service, at bargain prices (or prefarably free). To structure any quality public service provision, you have to focus on what people need, & not so much on what they want. We all have stories about equality, discrimination etc, but you need to work out what you can afford to put on the menu & how your chefs can deliver a quality dish, hot to the table, every time. Enjoy your basic meals, but if you want something we don't have, you have to find another place to eat  🍴

Hi Nicholas

When the person gets good meals by paying it affects none except the person, or his/her near and dear one who might see happiness in his happiness. Of course the provider/s of service also may feel happy in his happiness.

However, health is such that a unhealthy/sick person who can't afford basic/good service if starts spreading illness, the illness doesn't see who is rich and who is not and where to stop.

If I give birth to a crippled child (not my fault, not child's fault) I have to look after him because s/he is my product, as am I the product of my society. Therefore it is the responsibility of the society to provide health and education without any barriers, and individuals contribute (taxes, or any other form like service, etc.) as they already do. Well educated and healthier nation will raise the basic standards of people to at least a tolerable level, That is how I think, feel and follow.

I would love to have more input to see how people (thinkers and scientists) feel about the topic.

Regards

Suresh

**  Please do not view this post as a personal  commentary on human rights, cultural / class distinction or legitimising differentiation  :-)  **

Suresh:  I think that one of the main issues you raise, is that health & education should be provided without barriers. Yes - from an ideal perspective, this is what we should aim for, but cost is a barrier that cannot be ignored, even though it forces us to create inequality and to make horrible choices. The more we discover about illness, the greater chance we have to control it (it will never be a factor that is overcome). Likewise, the more we become educated, the greater our potential and expectations. These are wonderful ideals, but they have to be provided with resources (financial, cultural, human etc.) that individual nations feel they can afford. Despite our 'global society', our nations and cultures are very different. That does not mean that one is any better than the other, merely that they are different. Because of this, I think it utopian to expect a common consensus on what is basic, what people are entitled to, & how much money is raised from a population (& how it is raised) in order to provide these basic services ...

Theoretical questions: 

• If we pooled all of the worlds resources, would we be able to provide a basic level of healthcare and education for every individual on the planet?
• If everyone is basically healthy & educated, are there still the resources to support societies in which people can positively engage above a subsistence level?
• Are those that 'have' or 'want', likely to reduce their own potential development and conditions to support those that 'have not'?
• Given that we can only deal with existent resources, are we (given our human nature and history of development) likely to accept the progression of one group at the expense of another (however morally right it is)?

These are just conceptual questions & do not necessarily represent my own views. However, without opening an ambiguous discussion on morality, ethics & belief, I think your question can only be answered by looking firstly at the practical resources we have, and secondly, at the actual practices of individual societies in regard to how they determine what is needed and how they choose to distribute these resources.

The way our societies perceive and meet their responsibilities is different, and it is subject to mass as opposed to individual influence. Yes, the vast majority would like to see food on the table, good levels of education etc, but the reality is that groups within the society fight for dominance and this comes at the expense of others. All of our societies have strata & inequality, rich & poor etc. Thus is represented the dichotomy of what we would like to think (as individuals), and how we choose to exist (as societies). Personally, I view societies as groups in which we have learned to co-exist, and not groups that show equality & consensus. There is now a greater opportunity to move between these groups, & this movement is likely to have an osmotic effect, in regards to existence, development and aims. As groups strive to  better their circumstances, it often has a knock-on effect for others (world bank, labour migration etc.). These groups will react to these effects so difference & conflict are likely to continue. This has strong overtones of 'evolution' & 'survival of the fittest', but I have yet to see another plausible explanation that fits what we know of our past, and what we see happening in our present.

Whether moral, fiscal or societal, there is always 'payment' of some kind, and we make the choice as to what we can live with. That is why I feel that your question cannot begin to be addressed without some form of definition as to what is acceptable, what needs to be provided (simply saying basic 'healthcare' or 'education' is not precise enough), how it can be provided, what effects it will have for everyone (positive and negative), and whether the cost (in common good, individual benefit, available resources etc.) is acceptable to everyone ... 

Unless I take the situation, needs and views of everyone into account (regardless of how I see or measure them), then my individual opinion is likely to be of little consequence.

Dear George,

I too am sad to see you drew these answers, although they are precisely the same as those I would have drawn myself.  You are entirely correct when you say that it is a bad start, but when looked at over time & in relation to societal composition / human nature, I don't think it has ever been much different.  Lots would dismiss the view that 'we are what we are' as too naïve or simplistic, but these questions would suggest that it is true nonetheless.  We play the cards we're dealt  ;-)

Extending immediate attention to health care is perhaps the best thing that one can expect in this modern world. But in my view the system needs to be proactive and ensure less influence of critical disease  in life. One cannot afford be reactive and practice preventive health care all the time... 

Dear all

Thanx for your ongoing input. What would you think the principal reason for such a universal healthcare as is present today; lack of political will, or lack of finance/s? For me it is predominantly the lack of political will.

Regards

Suresh