Cost

I now take a more practical approach to fairness. Cost is a huge factor in modern medicine. In a recent piece, Daniel Callahan takes a look at the impact of rising costs on medicine. But what if new genetic engineering techniques come to the forefront? Likely, they would be enormously expensive. And, based on some of the research done for my previous posts, there might be a strong impulse to provide this care for the economically under-resourced. This could only serve to drive medical costs up even further. These costs, of course are borne by the average insurance ratepayer. Namely, you and I. This is where the fairness aspect comes in. Is it fair to make the healthy pay for this new genetic treatment? Would it be considered elective like plastic surgery? I know my insurance won't cover things like breast augmentation. And from a philosophical point of view, do we as the healthy, have a responsibility to the less so to help with their care? Even this question is explored in some of our readings. If we do have an obligation to help, where is that obligation rooted? Again, drawing from Sandel, we consider that the obligation to help is rooted in our more fortunate roll of the "genetic dice" but if our genetic makeup is no longer a chance but now an equation, does that obligation disappear? Quite the dilemma.