Cultural, socio-political, and historical forces shape the social institutions that protect both individuals and groups from harms. The health system is an organized set of societal responses to the health problems that threaten human wellbeing (Fields 2009). The object of interest in public health is protection from threats to health, in other words, protection against morbidity and mortality. The health system is a social mechanism devised to deal with morbidity and mortality as they affect the physiologic, psychological, institutional, and cultural domains of human activity (President’s Commission). Those components of wellbeing comprise society’s notion of health and disease. All of these domains change over time under their own …show more content…
In addition to these central activities, a host of community-based services and various forms of alternative and complementary medicine also serve important protective and rehabilitative functions. Also, given a determination that all members of society should have guaranteed access to adequate health care (the solidarity, wisdom, and prudence questions), how should we distribute the benefits of these systems equitably and share equitably the burdens of financing our mutual protection and aid? The problem of equitably distributing both benefits and burdens arises from our reciprocal commitments to one another in community. To resolve problems of fairness we always have to consider both the distribution of benefits and the distribution of burdens. For the distribution of health care benefits (guaranteed health care services) fairness calls for equitable access based on health care need. Equality among citizens follows on universal coverage. No citizen would be excluded (the solidarity question), although some needs (e.g., experimental treatments, cosmetic surgeries) might be excluded from the guarantee (the wisdom question). The benefit side of the fairness puzzle must look carefully at the content of the adequate care …show more content…
Health systems are a social response to common threats to individuals in the community. The degree of social commitment to defending against these threats becomes a matter of social and political choice. Who is included in the community, what threats merit social defenses, how fairness will guide both benefits and burdens, and how the necessary political dimension of health policies, form a multidimensional frame for this examination. We derived a checklist of twelve questions that can guide the evaluation of a specific proposal for health protections reform (for example, the Oregon Health Plan or the Medicare Health Proposal). (Norman, Strosberg, 2012). The same questions can easily be reformulated to guide an assessment of the status quo (Garland, vol. 8, no. 3, 241-54