Healthcare: is it a right or a luxury? | Tarik Sammour | TEDxAdelaide

What you don't understand is that they keep people unwell so they can control life and death.

TLDR: The question of whether healthcare is a right or a luxury is significantly less important than the question of how healthcare systems can be optimized to have the care be both cost-effective and high quality.

amazing! well done!!!!!!

This specific TEDx Talk motivated me to want to scroll through other TEDx Talks and see what other insight I can receive. This talk was wonderfully delivered and the information was presented in such a clear and concise way, so big thank you to the speaker Dr. Tarik Sammour!! I hope many more people view this video.

Let's grow up. A "right" is something determined by a ballot box or, unfortunately, by force.
Some right wing folks think they have access to divine or patriotic givens.

Top Payers by Profit in 2023:
Here are some of the top payers ranked by their 2023 profits:
UnitedHealth Group: Total net earnings of $22.4 billion (up 11.2% year over year).
CVS Health: Total net income of $8.3 billion (up from $4.3 billion in 2022).
Elevance Health: Total net income of $6 billion.
Cigna Group: Total net income of $5.2 billion.
Centene: Total net income of $2.7 billion.
Humana: Total net income of $2.5 billion

Profit Projections:
Based on updated and expanded projections, it is estimated that healthcare profit pools will grow at a 4 percent CAGR from $654 billion in 2021 to $790 billion in 20261

As of the most recent data available, there are 1,834 registered lobbyists working for pharmaceutical and health products. This means that the industry has more than three lobbyists for each member of Congress1. The pharmaceutical industry’s lobbying efforts play a significant role in shaping policies and legislation related to healthcare and drug pricing

In the US, we have 350 million people with an unending supply of migrants and transients. There is no way we can take care of all the indigents who freely and liberally use the healthcare system without having a negative impact on our citizens who have paid in to this system for their entire lives.

Well, people die without it, so I’m going to say it’s a right.

I am a doctor in a poor brazilian region, and I work as a primary care assistant of the public health system we are proud to have here. If it wasn’t the SUS, we had had no chance to make the pandemic out

Overall, I think this was a reasonably good presentation. However, it did have some flaws in it.

First, he casually mentioned "Death Panels". I know that, all the ranting by ill-informed Americans notwithstanding, no such things exist in Canada. As far as I'm aware, they don't exist in any other western democracy either. Simply mentioning them at all, without any offer of evidence that they exist anywhere is, in my opinion, irresponsible.

Second, he claimed that Canada's system is more "socialized" than Australia's system. I suppose that depends on your definition. Public spending on healthcare in Canada is lower per person than it is in Australia, while private spending out of individual pockets and private insurance plans is higher. That doesn't sound particularly more socialized to me.

Third, he claimed that healthcare cost will simply continue to soar ever higher. There is some truth to that. New technology is very expensive and medical technology is expanding rapidly. Older population will always need more care and more expensive care. Again True. But, as technology matures, it tends to get cheaper. What is cutting edge today, won't be in 20 years and its price will reflect that. Overall though, advancing technology and longer lifespans probably will have an inflationary effect on individual health care costs.

With all that said, the elephant in the room is the baby boom. Healthcare inflation at this moment in time is very heavily influenced by our demographics. Our population is aging. You can argue that this is because people are living longer and there is some truth to that. There's a lot more truth to the simple fact that we, in the west, had a baby boom between 1947-1960. Those boomers are now 63-76 years old. He's right. We all do have an expiry date. None of us live forever. In 25 years time, the youngest boomers will be 98 years old. The rest will be dead. The generation that followed the boomers, gen-X is a much smaller demographic. This is going to have a fairly dramatic effect on the median age of our population. It is going to continue to rise for a few more years, then it will plateau and then as the boomers die, it will decline quite significantly. This will have an effect on healthcare costs dramatically slowing and maybe even reversing the growth in costs.

Finally, he praised Australia as performing far better than Canada, the U.K. and the United States. Is that truly warranted? I'm going to set aside life expectancy here. Afterall, that's quantity. Instead, I'm going to focus on Healthy Life Expectancy (HALE). That's quality. In the United States, that number comes in at 66.1 years, in Britain 70.1 years, in Australia 70.9 years and in Canada 71.3 years. When compared to the United States, that pat on the back was well warranted, against Canada and the U.K., not so much.

He made a hugely important point near the end of his talk "Quality over Quantity". I will point out that, more often than not, the push for quantity over quality comes not from the patient, but from the patient's family. If we let the will of the patient drive the care, the patient will almost always choose quality over quantity. And, it's quantity of life, not quality of life, that tends to be extremely expensive.

So, here's my answer to his question. "Is healthcare a right?". Champagne and caviar healthcare is a luxury. Good quality healthcare is a right.

It is very interesting to have a view that is able to look at both sides of the coin. Also, that is able to acknowledge that on a global scale healthcare systems tend to be inefficient and prioritize people who are able to pay rather than giving equal care to everyone.

Totally agree there is ways to fix this universal healthcare
Charge water electricity and gas to the housing development low but charge also go do inspections to see how many people are there no just the one in the lease close the border and let’s get this place moving

As a Nurse I am amazed at this information.

Singapore is a great example of great healthcare financing, a good balance between the 2 extremes

If you want a serious discussion don't phrase it as a philosophical issue. You attract a lot Friedman fans who know little about the field .

I find the debate of whether or not healthcare is a right or a luxury to not be as important as many people who argue about it make it seem. I appreciated how Dr. Sammour ended his talk by pointing out that whether or not healthcare is a right or it is a luxury, it’s becoming more and more inaccessible either way.
Healthcare is a complex and expensive industry, requiring significant investments in research, technology, and infrastructure. As a result, healthcare services can be costly, and may only be accessible to those who can afford them. High healthcare costs put a significant burden on individuals and families. Many Americans struggle to afford healthcare, with some even choosing to forego necessary medical care due to cost concerns. This can lead to untreated illnesses and chronic health conditions, which can have serious long-term consequences for individuals and their families.
The increasing cost of healthcare needs to be addressed. I’m not going to pretend to know anything about the economics of healthcare in the United States, so I’ll leave the debating over different healthcare systems to people who actually know what they’re talking about, but I am willing and ready to listen to proposals of how to change our healthcare system in a way that makes this service, right or luxury, more available

I believe healthcare is a fundamental human right and should be available to every, regardless of their ability to pay. The provision of healthcare is essential for maintaining the health and well-being of individuals, and it should not be considered a luxury that is only available to those who can afford it.
The argument that healthcare is a luxury is based on the idea that it is an optional service, that caring for your fellow man is not a humanitarian obligation shared by us all. This perspective also fails to recognize the crucial role that healthcare plays in promoting social and economic development. Healthy individuals are much more productive and better able to contribute to society. When individuals are sick, they are unable to contribute to society, and the duration of such unproductive periods are substantially prolonged when healthcare is unavailable.
Furthermore, healthcare is a basic human right that is recognized by the United Nations. In 1948, the UN General Assembly adopted the Universal Declaration of Human Rights, which stated that "everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care." This declaration is a testament to the importance of healthcare as a fundamental human right that should be available to all individuals.
Moreover, the lack of access to healthcare disproportionately affects marginalized populations, including low-income individuals, racial and ethnic minorities, and people living in rural areas. These individuals are often faced with significant barriers to healthcare, including lack of transportation, discrimination, language barriers—all of which may lead to poorer health outcomes.
In addition, the provision of healthcare is a moral imperative that reflects a society's values and priorities. A society that prioritizes healthcare as a fundamental right demonstrates its commitment to the well-being of all its citizens. On the other hand, a society that views healthcare as a luxury reflects a mindset that values profits over people's lives and well-being.

I feel like the true answer to is healthcare a right or luxury depends heavily on what area of the world you live in. For example, Tarik was talking about how when looking at a job in the United States as a physician from Australia, his two kids, who were the poster child of health, still cost him around $25,000 per year to insure. What if he messed up the paperwork or couldn’t afford the premium? What would that have meant for his children if they got sick or needed any healthcare services whether that be acute or chronic? The United States is one of the richest nations economically and with that comes access to top-of-the-line technologies and resources across multiple areas, especially healthcare. And as a citizen you could have access to all of this amazing medical care to give yourself the best chance at surviving whatever medical condition you are going through, but it is at a cost. A very high cost that excludes many of people. So yes, you can have the best medical care, only if you could afford it.
I have also felt the similar dissonance and difficulty that Tarik had felt and experienced during his time in the United States healthcare system. We train to be doctors and sacrifice many things personally, professionally and financially at the opportunity to make a difference and help patients. It’s a sobering reality when we realize that this passion that drove us to go into this field is limited to the types of patients we can reach. We want to “do good” and “do no harm” to all patients we encounter as healthcare professionals, but are we really doing no harm by not giving healthcare access to the people who need it the most? A healthcare model that is exclusive and difficult to be a part of. The United States healthcare system reminds me of a top 100 golf course. You have to know someone on the inside as well as have the money to back it up in order to be part of the club. So that begs the question, is healthcare a right or luxury? Deep down I think we can all agree that a certain level of healthcare is a basic human right it’s just the logistics of this notion that makes it complicated and ambiguous. It seems like the two options are either resource limited healthcare for everyone or resource rich healthcare for the wealthy. Why are costs so high? I want to echo what Tarik said in that yes people are living longer with less quality of life which increases their healthcare needs substantially in the last decade of life. I agree that the hybrid system model (e.g. Australia) performs better over time compared to their extreme capitalistic and socialistic counterparts. We can agree that spending less with better outcomes is more than efficient. My favorite point in the presentation was Tarik encouraging healthcare providers to pay more attention to what things costs as well as being up front and honest about disclosing prices to patients. If each of us healthcare providers were more mindful and cut out little things that were either a waste or unnecessary, I think everyone would be shocked at the financial impact it would have on the system and the patients. Isn’t that the essence of “doing good” for our patients? Doing everything in our power to make sure they are well taken care of in a capacity to which they can sustain and afford?

For years people have been debating whether healthcare is a right or a luxury. Some people argue that the right to healthcare is a basic human right while others say that it is a luxury that people should pay for themselves. Those that believe that it is a right think everyone should have access to healthcare regardless of their financial situation. They would equate it to the right to food, shelter and clothing and that the government has a responsibility to provide those services to every citizen and be free/affordable for everyone. The World Health Organization (WHO) states that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being."
However, there are other people that believe that it is a luxury and you should be responsible for your own expenses as if it is a commodity that someone can purchase or not. It is believed that this facilitates competition among healthcare providers to provide better quality and more affordable healthcare services.
While both sides have valid points, the best solution lies somewhere in the middle of both of these extremes. It is fair that healthcare is a fundamental right and be able to be accessed by anyone but healthcare is an extremely expensive service and requires a lof of financial resources. It is imperative to find a balance between providing universal healthcare while also making sure that providers have the resources to be able to provide the best quality service.
The United States has the type of healthcare that is more of a commodity rather than a right which expects people to pay for their healthcare services through private insurance. But, this can lead to people not being able to afford the treatment they need and leaves many without access to the appropriate care. Other countries like Canada and the United Kingdom have universal healthcare that off free or affordable medical care to all of their citizens. The downside with this is that they can have long wait times for procedures that are not emergencies.
Overall, there are valid arguments for both standpoints but healthcare should be accessible to all individuals no matter if they can afford it or not. Healthcare is a basic life necessity in order for people to lead healthy and productive lives and I believe the government should make sure that is possible for all. Healthcare shouldn’t be seen as a luxury only available to some but rather accessible to all.

Despite being one of the wealthiest countries in the world, the US healthcare system faces many economic challenges that significantly impact the quality and availability of care. These issues raise significant ethical concerns regarding justice in healthcare. Specifically, equal access to healthcare, where the US healthcare system falls short. This is in part because millions of Americans do not have health insurance and in part because of the unbelievably high cost of care. Combined together, this creates significant disparities within different socioeconomic layers. Further, the high cost of healthcare leads to financial burdens and underutilization of medical services. According to a survey conducted by the Commonwealth Fund, around 37% of American adults reported either not going to the doctor, not filling a prescription, or skipping a recommended medical test or treatment in 2020 due to cost concerns. Additionally, around 23% of adults with health insurance reported having trouble paying their medical bills. A related issue with healthcare economics in the US is the impact of high costs on public services which limits the resources available for their initiatives. The best example being that the CDC's budget has been cut by around 10% since 2010, after adjusting for inflation according to NPR. Justice in healthcare requires that individuals have access to necessary medical care regardless of their ability to pay. The US healthcare system fails to meet this standard and denies many patients from one of the most basic rights. Another aspect of justice where the US healthcare fails is the equitable distribution of resources. For example, according to a report by the National Alliance on Mental Illness (NAMI), racial and ethnic minorities in the US are less likely to have access to mental health services than their white counterparts. The report cites a study that found that only 8.7% of African Americans and 6.8% of Hispanic Americans used mental health services in 2015, compared to 16.8% of non-Hispanic white Americans. These disparities are often directly related to social and economic factors, such as income and education level. As healthcare professionals and policymakers, it is essential that we prioritize justice in healthcare and work towards creating a healthcare system that is accessible, equitable, and accountable to the needs of all individuals.

I cannot agree more with the push for physicians and hospitals to be more transparent in the cost of procedures and the ways in which a patient can pay for their healthcare in a way that works best for them. My wife gave birth to our first child just a year before I started medical school and when we were preparing for the hospital stay, we had several friends and family approach us regarding the best way to pay for our child. Little did we know that the OBGYN office we had been going to because they were covered by my insurance were slowly charging us the amount, we would need to pay to cover our deductible by the time our child was born. While this may seem like a good gesture by our physician, in the end we paid more for the clinic visits and the hospital visit through insurance than we would have had we gone paying out of pocket. This almost feels like a breach on my ethical right to autonomy and justice. While we did receive great care and I truly believe the physicians had our best interests at heart, we did not understand the cost of having our baby because no one wants to work with a patient they’d rather see how much money they can get from the insurance and other organizations.
Many individuals continue to push for a social healthcare system within the U.S. and many others push back stating that the cost to the taxpayer would be too much of a burden and not be fair to the population as a whole. While both sides bring up valid arguments, I think Dr. Sammour brings up a really good point of the ideal system being a hybrid. If instead of trying to replicate a system that is already in place, and we try and establish a new norm of being transparent with our costs and being focused on providing quality over quantity we may be able to revolutionize the system into something that actually works. Our society has become so hyper focused on the need to obtain money and status that doctors are often looked at as money hungry individuals who could care less about the health of their patient and more about which watch goes best with their new car. However, because of these few individuals who focus on the quantity over quality of care, those physicians out there who truly work tirelessly to improve healthcare in their communities are overlooked and not given the chance to help implement real change. We need to return to the root reason for healthcare, which is to provide healing to those in need and improving the quality of life within our communities.

Thank you for this talk. You made some very good points and I appreciate your humor and good-natured delivery despite the controversial topic. I am an American medical student and there are a lot of things about the American system that are concerning to me. I am very much opposed to fully socialized systems because it is still ultimately very costly to citizens in the form of taxes, and the quality and availability go way down. I agree with you that the cost of healthcare in the United States is astronomical and something needs to be done about that. I would disagree with you though. We actually do have a lot of socialized medicine in the United States, it is a hybrid system, not fully private. This is partly, in my opinion, why healthcare is so expensive in the United States. Our socialized programs such as Medicaid and Medicare are tax funded government safety nets for the elderly, impoverished, and children. There is not a child in the US, as you say, without parents or with impoverished parents who is not eligible for Medicaid and thus free access to all high-quality healthcare that they may need. The truly disadvantaged in the American system or the middle-class people who do not have unlimited wealth to pay for whatever healthcare they need, but do not qualify for the government safety nets. I would even include the speaker in this TED talk in that category. Yes, he is probably making 500-600 thousand dollars a year working as a surgeon in the United States, but of course he is still going to feel the sting of having to pay $25,000 a year for his health insurance. But not nearly as much sting as he would feel if his taxes went from 40% up to 60% a year in order to pay for a socialist system. There is a reason he is choosing to practice in the US. Not to mention, if his child had cancer, I’m sure he would gladly pay the $25,000 a year and have his child treated in “the world’s best cancer hospital” that is incidentally in the United States. Now, quickly back to why healthcare is so expensive in the United States. I agree 100% with the speaker. The costs of healthcare need to be made way more transparent. Nowhere else in society would you buy something without looking at the price tag first. The prices need to be transparent and made standardized. Standardized prices would prevent private insurances and government safety nets from dictating price by only paying a fraction of the billed price. With standardized prices, the negotiation between hospitals and insurance companies over reimbursement would go away and prices would stop being driven up by these negotiations. I also believe that physicians should own and more hospitals and be in executive roles, while still attending to some clinical duties. They must look the patients in the eyes and make treatment plans and they will be more likely to see patients instead of profits. Business executives can easily slip into the trap of fixating on their bottom line.

Tarik addresses a very difficult discussion about whether healthcare is a right or luxury. In the United States we have cutting edge technology because its creation is rewarded monetarily. This has created so much injustice in our society because only the wealthy and insured have access. The solialized health care sytems struggle monetarily as well, and has created a mediocre health care system, for everyone. There is no perfect solution but he does mention Australia’s model of healthcare that lies in the middle of of these two polar opposites. They spend a significantly less amount of money on health care that is in the middle of quality as well. It feels unjust to only benefit those with a lot of money, but it is also unjust to only give mediocre care when people have the ability and resources to create life saving state of the art solutions to medical problems. By reducing the access to life saving treatment but making it more affordable may even be called maleficence. As physicians we are called to promote justice, beneficence, non-maleficence, and autonomy. Justice includes providing access to medicine for everyone, and beneficence includes providing the best care possible. I liked Tarik’s point about making our healthcare costs more efficient. Making sure that we understand the efficacy of using certain tests and tools and disregarding them if there’s no evidence of improvement over cheaper options. I also very much agree with giving the patients more autonomy over their healthcare. Telling them how much things cost, what other options are, and letting the choose if they want their life prolonged or not. This would cut costs down dramatically. I know the barrier to this is that it would cause harm to the patient if they were taken off the ventilator and passed away but this may be the patients preference and we must respect that. I think as physicians we need to promote quality of life over quantity and be more transparent about costs of healthcare with patients.

In this talk Dr. Sammour does an incredible job of highlighting a major problem in the United States and provides what seems to be an appropriate solution to the conflict of universal healthcare. While highlighting the expenses and outcomes of healthcare in the United States, he compares costs and outcomes with nations who follow a socialist, healthcare for all, model. The benefit of this model is that it follows the ethical principle of equity, as everyone is provided the same level of care, options for treatment and physicians. While this model may sound appealing to some, it also comes with long wait times to be seen, limited choices in healthcare decisions and provider decisions. Those in favor of the USA model of healthcare argue that individuals should be able to make choices surrounding their healthcare, even if that choice comes at an astronomical price. The socialist healthcare system also follows the principle of beneficence, as there is healthcare being provided for the greater good of the nation. The American healthcare system breaks several of the ethical principles, such as equity, as individuals must pay for many things that they wish to have which creates an economic disparity within the country. While the USA provides Medicaid and Medicare, many states have limited resources toward theses programs. These programs also limit one’s ability to choose their provider and when to be seen. It should be noted that Dr. Sammour discusses how Australia has a combination of the above-mentioned programs. By integrating healthcare for all, the principles of equity, beneficence and justice are validated. By providing individuals with the option to pay for further or more advanced or different healthcare, they are allowing patients to maintain autonomy and act in ways that benefit that individual specifically.

I think this was an incredible talk with great perspective regarding healthcare systems. Recognizing there is an issue with the US healthcare system today is the first step in reform. However, is reform even possible with regards to this matter? I think there absolutely should be. Though there exist advantages to private health, such as more options and more sophisticated facilities, privatization of health insurance essentially divides the “have’s” and “have nots.” There is a biomedical ethical principle known as justice (specifically distributive justice) which describes fairness in what people receive. As private health insurance becomes more expensive, only the “haves” get to endure the benefits mentioned earlier, fundamentally disallowing justice in medicine. Naturally individuals are “lost in the cracks” in this type of system. There has to be a better way to deliver healthcare, and I believe Mr. Sammour has the right idea, focusing on quality rather than quantity and being cost aware. I am not necessarily a fan of socialized medicine because there are people in this world who work very hard to enjoy the life they have and there are people who depend on government assistance, enjoying a life they may not deserve. Socialized medicine in my understanding would perpetuate this dilemma. Sometimes there is never a great solution that which benefits all parties and healthcare delivery in the US very well could fall into this category.

I have great respect for Dr. Sammour's willingness to address such a difficult topic. There is no question that healthcare is getting better as shown by the profoundly prolonged average lifespan compared to what it was even 50 years ago. But the unfortunate side is that while it is continuing to get better, the costs surrounding it continue to increase. This presents a difficult ethical problem that Dr. Sammour addressed when he said that if we want to have government-funded, perfectly equal healthcare for everyone, we have to be ok with other things such as the death penalty. There does not seem to be a good clear answer to this difficult situation. When posed with the question of healthcare as a right or privilege, my initial inclination is to immediately answer that it is a right. Suggesting otherwise is to say that one person is allowed to live and another dies only because the one who lived had more money. This sounds like a terrible violation of moral ethics, but on the other side, would science and society continue to progress if healthcare funding was standardized (and surly decreased)? Here's my idea (keep in mind that I am just a guy on the internet). What if everyone had an allotted amount of government funding that they could use specifically for healthcare? Sufficient funding to cover easily treatable, but often fatal diseases (i.e. appendicitis). Or midlevel care for more difficult diagnoses like cancer or autoimmune disorders. That way everyone could at least have access to some type of care.

I loved this talk!! Makes you think...

Dr. Sammour brought up an interesting point of view of one of his colleagues that he had an interaction with. Healthcare continuously gets more expensive for patients to have access to and get quality healthcare for themselves and family. I feel there is an ethical dilemma with this, the right to health and the principle of distributive justice. On one side, many people would argue that healthcare is a basic human right and that every person should have access to affordable healthcare. This is based on the idea that every human being has the right to a healthy life and healthcare would be essential for achieving this goal. On the other side, some argue that healthcare should be earned rather than a right or guaranteed. They would believe that people should have to work and contribute to society to earn the privilege of receiving healthcare. This is a complex ethical issue when we consider the fact that access to healthcare is linked to social and economic factors, like income, education and social status. Dr. Sammour made a lot of good points on how either a more privatized or socialist healthcare system is not as efficient. We could approach this question by creating a hybrid system between these two types of healthcare systems. His idea of being aware of the cost of equipment is really interesting and could eliminate some unnecessary costs like the wound dressing he mentioned. His last point of quality over quantity of patient’s lives. Quality of life for any patient at a reasonable cost should be a high priority for patients as healthcare continues to get expensive for people to afford.

Healthcare in one way or another is something that every single person on this planet will need at one time. Many regards healthcare as a basic human right to which each and every person should have access to regardless of their financial status. Moreover, access to adequate and good healthcare is essential to living a happy, healthy and productive life. Denying this right based on financial considerations is morally and ethically wrong. Healthcare without a doubt is a basic human need, much like food, water and proper shelter is. It is not a question of if but when a person will fall ill or sick at some point during their lifetime. When this occurs often times, they will require medical attention to fully recover from this illness. This simple example shows that access to healthcare is not a luxury but in face a necessity for everyone’s life. Denying such access can have dire consequences on health not only on the individual but also the community itself. The World Health Organization (WHO) itself states that healthcare indeed is a basic human right and everyone should have adequate access to it regardless or race, socioeconomic status, or religious beliefs. Providing the best healthcare to a community ensures equality and social justice by allowing every individual equally opportunity to lead a healthy life. Denial of this right based on social status or financial reasons is unjust and would without a doubt lead to disparities in healthcare outcomes. Reiterating on previous statements, providing adequate access to healthcare is essential to promoting community well-being and public health. Access to healthcare promotes individuals to seek medical attention when one may fall ill. Helping to prevent spread of diseases within the community and thus improve overall health outcomes for members of the community This benefit to a society as a whole will help to reduce the overall cost of healthcare to the community while also enhancing the quality of life to individuals in the community. Healthcare access is without a doubt an ethical issue that requires moral obligations to provide care to those who need it most. Medical providers should lobby based on the oath we all take to provide care to all regardless of their financial status. Denial of this right is wrong and as we a community should explore new options to ensure each and every person has the ability to access healthcare no matter their situation.

Through his personal experience, Dr. Sammour shares his viewpoint on whether healthcare should be a luxury or a right, similar to how most people might – based on their perception of how their personal experiences have been valued through respective medical systems. I personally resonated with his passion towards exploring how the unjust, unsocialized healthcare system of the United States, in comparison to Australia and New Zealand’s socialized public system affects children who might not have parents who have health insurances that can provide for their complete healthcare needs. As many insurance programs and coverages for families are attached to employment of parents, this can be terrifying as in a society with unlimited resources and innovative medical technology many people can unfortunately be left without access to care in the Western society. In contrast to describing the unfairness that children, unaware of the complexities of healthcare coverage, experience, Dr. Sammour exemplifies the average aging population only increasing in Australia, however with the needs of increased healthcare access for maintenance. Now, if we compare this to the access that an aging population might receive in Western medicine, the average age might not be as high as healthcare access in granted based on financial standing and insurance, seen as a luxury not a birthright as in other societies. Healthcare systems across the world are extremely unbalanced in the access that patients receive and the debt they may hold for receiving critical care. In the states, Dr. Sammour compares healthcare systems to business-like systems set on generating volumes of revenue, but when referencing Australia’s system, he mentions how they spend a less amount of total revenue on providing care, but overall having better outcomes. I truly don’t see how the medical systems can adapt to reflect each other, and provide for better patient outcomes in a quick transition, but I do hope certain practices begin implementation especially as we all might encounter tricky situations with patient financial interrupting and complicating care as future healthcare providers and physicians.

I think it is very difficult to discuss whether healthcare is a right or a luxury with an unbiased opinion, but Tarik Sammour does a fantastic job analyzing both sides to the argument. Economics and politics now play a large role into the aspect of healthcare, and most countries have adopted the extreme ends of the spectrum between healthcare for all and healthcare for those who can afford it. This directly relates to the medical ethics principle of justice, which refers to a fair and equitable distribution of health resources. Universal healthcare aims to provide this type of equal access to resources, but as Tarik points out, there is a lack of good qualitative outcomes. How as a society can we find an equal balance between high-quality and affordable healthcare? Ensuring equitable access to healthcare, especially in countries like the United States, would be one of the most expensive acts of justice to date. I really appreciate the point Tarik made about the longevity of individuals nowadays with all the advances in medical technology. Just because we can extend someone’s life, is prolonging the inevitable really going to make a positive impact? With most of our healthcare expenses going to the 85 and older population, how might we judge what is considered “equitable access,” when these individuals require more than the average? On the other hand, privatizing healthcare would certainly continue to produce advancing technology for these individuals but would only be available to the ones who can afford it. If you are a physician and know of a live-saving medication for your patient, but they cannot afford it, what do you do? Violate not only the justice principle, but also the principle of beneficence and not administer the medication? Or save the patient, but with an associated cost? The balance between doing what is right and doing what is economically justified may never be found, but I believe that if we, as a society, find a common ground on the stance of healthcare, we might be one step further to obtaining this balance.

This talk that Dr. Tarik Sammour provided was an interesting perspective on an age old argument. If I was initially asked on whether healthcare is a right or a luxury, my immediate gut reaction would be that healthcare is a right. This idea largely stems from the ethical principles of both non-maleficence and justice. In the realm of justice, it’s believed that all individuals that enter a hospital or clinic should be treated equally and equitably. With that in mind, by not providing access to care to individuals, one could argue that this would go against both justice and non-maleficence (aiming to do no harm). However, an interesting point that Dr. Sammour brought up was the healthcare system’s goals in prolonging life without consideration of quality in life. It could be argued that if all individuals receive care to prolong life, but that life ultimately ends in living in pain, financial debt, and isolation, is it truly respecting the ethical principle of justice?
Dr. Sammour also brings up the idea of appreciating the financial value in the tools/technology we utilize when providing care while also understanding when to cut costs. Bringing back this idea of prioritizing quality of life, it makes me wonder whether the American healthcare system should learn to cut costs in materials whose quality does not bring value and redirect those funds to supplement other aspects of healthcare. Specifically, I believe that putting in funding for nursing homes and assisted living facilities could be a way to increase our patients’ quality of life. Personally speaking, I have seen nursing homes that have been understaffed and overworked. By increasing funding, perhaps these organizations can provide increased quality of care to their patients while also increasing access to activities that promote socialization and mental/physical stimulation. Thus, prioritizing quality of life over simply prolonging life.
As Dr. Sammour suggests, I believe that the healthcare system has further work to do in finding a balance in improving access to care without neglecting the quality of life.

Sammour’s speech raises an important ethical questions about the role of healthcare in society. From an ethical perspective, healthcare is not just a matter of individual preference or market forces but rather a fundamental aspect of human well-being and dignity. In my opinion, his talk is well balanced and thoroughly thought out in a reasonable way. He discusses how as a society obsessed with treatments and prolonging of life, we have almost dug ourselves into a hole and created treatments that are expensive not only in their own right but also because they are highly sought after.
He lays out a 3 point plan in which the first point he makes is that the healthcare system needs to be a hybrid of both social and private healthcare because both have benefits and pitfalls. In combining these two systems which Australia has tried to implement, we can create a system that becomes both a right and a luxury. The second point he makes is that we as healthcare professionals need to care about cost. Healthcare has become so expensive because we believe that more expensive yields better results. For example, studies have shown that there is no significant difference in wound bandages yet providers choose to use the more expensive option.
As Sammour argues, healthcare is not a luxury that only the wealthy can afford but a right that should be accessible to all. This perspective is supported by a range of ethical theories including utilitarianism, which prioritizes the greatest good for the greatest number of people and the principles of justice and fairness, which demand equal access to basic good and services.
From an ethical standpoint, providing universal access to healthcare is not just a matter of meeting a basic need but also of fulfilling moral obligations to promote the well-being of all members of society.

I whole-heartedly agree. Healthcare is a topic that touches the lives of every individual, and the question of whether it is a right or a luxury is a crucial one. As human beings, we all have a right to good health and wellbeing. Denying individuals access to healthcare can have serious consequences for not only them but for society as a whole. People who do not have access to healthcare are at greater risk for chronic diseases and illnesses, which can lead to increased morbidity and mortality rates. This can have a negative impact on economic productivity, healthcare costs, and social development.
Additionally, healthcare is not just a matter of providing medical treatment for those who are sick. It is also about promoting healthy lifestyles and preventive measures to reduce the burden of disease. Universal access to healthcare services can help to improve health outcomes and reduce health disparities among different population groups. Often healthcare is inaccessible to the most vulnerable communities and populations like people of color, low income individuals and those with disabilities. Not supporting a right to healthcare for all only further extends the gap in equality and perpetuates poverty. These groups are more likely to suffer from illnesses that are preventable and chronic illnesses. Studies have consistently shown that individuals living in poverty or with low income have a much higher chance of developing chronic diseases such as hypertension, diabetes and obesity. Creating a universal basic healthcare system can help alleviate the stress that is placed on these groups.
Medical ethics and principles of social justice support the fact that healthcare is a basic human right. As healthcare professionals, it is our duty to provide care to all individuals, regardless of their ability to pay or social status. This is reflected in the Hippocratic Oath taken by medical practitioners.
Healthcare is not a luxury but a fundamental human right. We must work towards creating a system that prioritizes the health and well-being of all individuals, regardless of their background or financial status.

I would like to start by saying thank you to Mr. Sammour for sharing his knowledge with us and enlightening us with his years of experience that have led to this great perspective. What a fantastic discussion this is. One of the most controversial topics in healthcare today, and I think that Mr. Sammour “hit it out of the park”. His proposed 3 step plan towards the end of the video I think is great, however quite vague, and I hope to shed some of my perspective on the subject. In my advanced medical ethics course we talk very heavily about beneficence, which means to promote the most good for our patients. Now, I am personally in favor of private sector medicine, to an extent of course. I, respectfully, believe that private sector medicine has gone too far, and is starting to violate the principle of beneficence. I would like to take the perspective that healthcare is run too much like a business now. The fact is, physicians go to school for an average of 13 years, go hundreds of thousands of dollars into debt, and become doctors, which in latin “docre” means to teach. Physicians do all of this work to be told by somebody with no clinical experience how to manage our patients and I think this is why I think the principle of beneficence is being violated. The perspective is beginning to radically shift from “promote the most good” to “how do we make money from this”.
Mr. Sammour was trying to find the middle ground in the aforementioned statement. I believe that in the sprit of beneficence we need to start researching which procedures can be omitted and considered unnecessary in patient care in order to make patient care affordable from the patients perspective, not from the hospitals’ revenue perspective. This research will take time though because we need to ensure that risk never outweighs benefit when considering omitting procedures. I think that we as a society moving forward will find the middle ground and can achieve a compromise that keeps the patients and the hospitals prosperous with health and money. Thank you for reading.

An ethical principle that must be considered in the debate between quality of life and quantity of life is the principle of beneficence, which holds that healthcare providers should act in the best interests of their patients and promote their well-being. According to a paper published in the Journal of Palliative Medicine, the principle of beneficence requires healthcare providers to consider both quantity and quality of life when making treatment decisions for patients with serious illnesses. The authors argue that in some cases, interventions that extend life may be in the patient's best interests, even if those interventions come with significant risks or side effects. They note, however, that in other cases, the pursuit of quantity of life may be counterproductive, and that patients may be better served by interventions that improve their quality of life, even if those interventions do not extend their lifespan. The authors suggest that healthcare providers must engage in a nuanced assessment of each patient's situation in order to determine the most appropriate course of action. They argue that this assessment should take into account the patient's values and preferences, as well as the potential risks and benefits of each treatment option. In conclusion, the principle of beneficence suggests that healthcare providers must consider both quality of life and quantity of life when making treatment decisions for seriously ill patients. By engaging in a thoughtful and individualized assessment of each patient's situation, providers can work to promote the best possible outcomes for their patients while respecting their autonomy and values.

Reference: Moss, A. H., & Bobinski, M. A. (2016). Quality vs quantity of life for seriously ill patients: a delicate balance. Journal of Palliative Medicine, 19(4), 349-350. doi:10.1089/jpm.2015.0606

In his talk Dr. Sammour discusses about 2 ethical principles. To start with the obvious, he discusses about distributive justice. This is fairness in what people receive. Although the public system that he discusses provides fairness in healthcare across the board, there is the discussion of monetary costs for healthcare; therefore, the quality of healthcare decreases. This is where beneficence comes into play which is to promote good. If there is a lack in quality of healthcare, then is that fulfilling beneficence? Now, to the privatized system which lacks in distributive justice, but increases the quality of healthcare due to having a massive number of resources which could be argued to promote beneficence. However, Dr. Sammour argues that the best healthcare system is one that balances both. Which by utilizing ethical principles, this would promote beneficence and also would have distributive justice. One specific point he made that I would like to focus on is the quality of life vs quantity of life. This goes towards beneficence which means to promote good which can be up for debate as to what is good, but I agree with Dr. Sammour in that preserving life for the sake of quality rather than quantity is key in a good healthcare system. I believe this is good and if a patient feels preserving their life in order to live longer is better than that can lead towards beneficence as well, but society should not be chasing this idea of “immortality.” In an ideal healthcare system, the quality of a person’s life should be prioritized.

It is a very interesting topic and I enjoy reading all comments here. I personally have an eye-opening experience too, because I never thought that a hybrid system exists and actually works. I was convinced that this is impossible to find the “golden middle” of two extremes. I lived during socialism in my country, and I see the different systems here in the US. I like some parts of each system and see where they both can be weak. My uneducated guess is that in a socialist country by paying less to doctors we probably can create more altruistic doctors working almost for nothing in comparison to a capitalistic country, but they are still not enough in number to cover all the population. However, I met good doctors in both countries and cannot support my guess. But I would also agree that a good salary can be a good motivation for anybody pushing them to work on self-improvement, to become a better specialist, to become a better doctor who can deliver better care to patients. On the other hand, it is frustrating to see how much healthcare has become more about business and care less about helping patients no matter what. There are so many organizations (that look like keep growing in number in past years) who want to be part of the healthcare system, and collect the profit, which sounds to me very unethical, and inappropriate action when we talk about “help” and should not be a “sale”. I think that we don’t need to have so many insurance companies which create more price raises, that in the end affect patients, while they compete for a better place in the market or other goals they try to achieve.
I liked very much Dr. Summour’s comment about the quality of life over the quantity of life. In the end, this is patient autonomy to decide what they want to do with their life. It would be true in any case: if they want to have quality and cancel treatments for prolonging life or if the patient is asking to extend their life over quality. This is still their choice of what to pursue during a terminal illness no matter what the doctor or patient's family wished to do.
Also, Dr. Summour’s brought up a good point that we all as a society should work together toward our goals, to improve our healthcare system. I do believe that we all can participate and contribute to its transformation process even if it does not look easy or we don't see ways how.
It is a great talk, very educating, and brings fresh thoughts to reflect on an effective healthcare system.

Dr. Sammour brings up a very interesting point when he talks about the cost of healthcare. He poses the question do you want your doctor to be worrying about the cost of everything around them when operating or the rather the task at hand? I would argue I wouldn’t want my doctor to be thinking about the cost during the operation but that doesn’t mean the cost of treatment is never discussed. I believe Dr. Sammour makes a strong argument when he states that we as healthcare providers and patients need to be talking about the cost and why. This is a great example of the ethical principle of beneficence which physicians make an oath to uphold. Beneficence states physicians provide benefits to persons and contribute to their welfare; in simpler terms ‘do good’. Physicians need to take into account the cost of treatments without decreasing the quality of care. Dr. Sammour mentions that physicians and patients should stop equating price with quality of care. Medicine is not a one size fits all. The care that is provided is different for each and every patient. The great thing about medicine is that there are many different avenues that can be taken and it does not need to be a one size fits all situation. Patients and doctors need to have the difficult conversations in this case about the cost of treatments.

In this Ted talk, Tarik Sammour, an Australian physician discusses healthcare systems and ways to improve it. By following the system and principles that he outlined will allow patients to have more autonomy and will provide improved patient outcomes.

The two healthcare systems he describes are a socialist model and a privatized model. Some of the strengths of a socialized healthcare are that it can be more equitable and altruistic. However, this is often times limited by lack of resources and slower innovation. In a privatized system, they are often very innovative and have the latest technology. However, the biggest drawback is the biggest draw back is the focus on making profits which disenfranchises those who do not have the means to afford the care. Sammour said, “we are rapidly approaching the day that our healthcare will be unaffordable due to a product of our own success causing the population average life expectancy to increase.” This is very true as our knowledge and technology expand, so does the cost of healthcare. This is why a combination of socialist and privatized healthcare would allow for more patients to access cutting edge technology without creating such a high cost burden.

The three methods that he outlined would also allow anyone within any healthcare system to be able to provide better patient care even with the inherent limitations of each system. In order for one to be a patient advocate one must understand the healthcare system that one is a part of. This allows one to be able to talk to patients about certain limitations and advantages of the care they receive. Allowing the patient to make a more informed choice.

Additionally, it is important for doctors to understand the cost of treatment. Many physicians adopt the utilitarianism point of view where the ends justify the means. They will use anything at there disposal without considering the cost to the patient. This can lead to high financial burdens for patients. It is important for physicians to understand the cost of the materials and equipment they use to ensure that everything used is strictly for the patients benefit.

Finally, healthcare should be about improving a patient’s quality of life not just extending the amount of time someone lives. To illustrate this point, he used the example of a discussion that he had with a 94 year old patient who had colon cancer. They discussed how treatment would have significantly decreased his quality of life, but would prolong how long he lived. The patient ultimately decided to not undergo the treatment and expired from the cancer. Taking the time to have this conversation is vital. It grants the patient greater autonomy and allows them to make the decision that is best for them.

A mixed privatized and socialist healthcare system that and healthcare professionals who use these three methods will ultimately allow for patients to have more autonomy. This is why I agree with these things that he outlined. I want everyone to be able to obtain high quality healthcare, to have greater control of the cost of healthcare, and to be more informed so they can advocate for themselves.

Dr. Sammour did an incredible job describing a position that is difficult to consider as an individual consumer. As he pointed out, as the patient we usually want the best care and if necessary, life saving measures to be taken. But if we consider the quality of life versus a quantity of life, we might as answer differently depending on the situation. He eloquently took a bird’s eye perspective of the pros and cons of both the public and the private health care systems that he has experienced in both the US and Australia. The ethical question at hand is justice. When we think about justice, it is about whether something is lawful, if it is a patient’s right, and if it is fair for the patient. Is there justice in providing marginal care for many or providing access to premier healthcare to a few? I think Dr. Sammour hit the nail on the head in suggesting that there is a balance in public and private health care. But have we agreed as a society, as least in the US, what the minimum health services are? When do we cross the line from right to luxury? This is what the healthcare reform battles in the US seem to be about. For example, is receiving insulin at a reasonable cost a right or a luxury? I think until politicians can come together to find a reasonable compromise between the two poles, physicians need to be transparent and be able to provide comparable alternatives to patients. This would require physicians partnering with their patients instead of taking a paternalistic stance. In addition, physicians should be having earlier conversations with patients discussing what a quality of life would look like for each of them. Many times, the highest costs of healthcare come at end of life. Being transparent and honest about these realities could not only improve our society’s views on healthcare but also the economics of it all.

I chose this TedTalk just based off of the title. This is a topic that I am passionate about, and I think should be discussed by those in or going into the healthcare field. From an ethical perspecitce, it is important to think about the ethical prinicpal of Justice where as health care providers we are there to equablly distribute benefits, risk, costs and resources to all of our patients. That can make it hard to have a tiered system as not everyone can afford the highest of the levels which goes against the that justice principle. I wonder if there is a way we can help “level” the “playing” field. I think that it is going to be hard to do in one go, because it has become such a web here in the United States, where there are many people especially in politics that deal with these decisions. There was another point that Dr. Sammour made when he said that as healthcare providers we need to start protioritzing quality of ones’s life over the quantity of their life. This plays into the ethical principle of Beneficence, where we act in the benefit of our patients which means being proactive in their health care, and helping improve their day to day lives.

I think Dr. Sammour articulates some great points here. Like most things in life, the happy medium between complex issues is generally where the ideal solution to a problem is. From an ethical perspective, however, I think the question of justice to patients of our healthcare system is the biggest element at play: Are patients getting the best care they can receive in a more tiered healthcare system or a more socialist-based healthcare system? On one hand, free healthcare for all results in mediocre healthcare at best for everyone. Yet, in a tiered system, those who can afford it do have access to top-of-the-line care. And unfortunately, there really is a finite number of resources and practitioners available to provide care. Thus, there is one important factor that I believe should be considered in this analysis: how we as people also directly impact our own health in our lifestyle and the decisions that we make. There are certain lifestyles/choices that have proven to be associated with deleterious health effects ranging from physical injury to untreatable infections and diseases. This is not at all to imply that people who make decisions (intentionally, unintentionally, or apathetically) that negatively affect their health should be left out to dry OR that some medical conditions aren’t simply inevitable. But rather, that the cost of medical care should be better accommodating for patients who generally live more health consciously AND we as medical professionals must educate our patients thoroughly about these associations, big or small. Hopefully this will in turn, encourage better lifestyles/choices that support better health outcomes and less need for extremely specialized, nuanced, and advanced care.

How do we fix this system in America? I also grew up in a country that had socialized medicine, and moved to America and have experienced the differences of health care from my family back home in Slovakia and how medicine is here. As Dr. Sammour mentioned, we have some of the best medical care in the world with unlimited resources, yet for every patient is treated, “another would get rejected.” As physicians, how do we choose who gets the care and who doesn’t? His colleague mentioning how you have to choose either high quality health care for some, or you have to expect rationing, because it is simply too expensive. Unfortunately, the reality of our world is that this is true, we either have expensive health care for some who can afford it, or we have poorer health care for all. Can we somehow meet in the middle for this? Three tier system is important: public health expenditure on health care needs to be balanced in private and public well-funded health care model. What will it take to be able to figure out having a balance in both? The question should be are we as a society willing to make the right choices so that we can continue to achieve those goals, or are we going to stand by and watch, as our rights AND our luxuries become more and more inaccessible to us.

This concept is an ongoing debate within the United States healthcare system that becomes evermore relevant each day as healthcare continues to become increasingly expensive and inaccessible to so many. Unfortunately, the problem is so overwhelmingly large and complex, that a simple solution is not feasible. As a medical student fronting this challenge head-on, I think it is worthy to reflect on the Hippocratic Oath that we all promise to uphold throughout our time as students and physicians; “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

I agree that a hybrid system tries to leverage the best of both systems, but I’m concerned that the cost of healthcare in a group payer system does not allow for patient autonomy. With limited resources paid for by the collective population, patient might be denied services that they consider important for their quality of life. While the example patient was older, should younger patients be allowed access to potentially costly procedures because of age that others might not be able to access. The cost of healthcare is important, but it should not be the most important ethical consideration. I wonder if it is best for countries to diversify their health care systems from one another allowing for trialing of different innovations in health care. If we all have the same systems that are hybrid, options for patients are more limited.

Dr. Sammour makes several excellent points regarding the two predominant perspectives taken regarding healthcare in western countries, namely, the approach to healthcare as a human right or the approach wherein healthcare is a luxury only for those able to afford it. While the principal of beneficence in medical ethics constrains a physician to act for the benefit of the patient, a physician would be upholding this principal in either case described by Dr. Sammour. They might be working for the benefit of the few and privileged who can afford their care under a system constrained by private health insurance, or they might be working for the benefit of all members of their society if they so happen to belong to one offering free healthcare. In both cases the physicians themselves are upholding the principal of beneficence. What if, however, healthcare providers had a more utilitarian approach to providing healthcare? What if the goal were to provide the best possible care to the greatest number of people possible? Dr. Sammour alludes to this in his final comments as he suggests taking what we can from each of the established approaches to medical care and creating an approach to healthcare that would assume healthcare to be both a right and a luxury. By approaching our understanding of the ethical principal of beneficence through the lens of a utilitarian, we can make it our goal to make changes to our current system that would still allow for innovation, while simultaneously increase the number of individuals who have access to that care. It may require a shift in how we as a culture view life and death in terms of quality and quantity as Dr. Sammour suggests, but in making that shift we may set the stage for a system of healthcare that provides excellent care to all members of its society.

Dr. Sammour does a wonderful job presenting the issue of private vs public healthcare systems that allows a realistic perspective that the perfect healthcare system does not exist. He states that there is a choice to have mediocre care for all or good healthcare on tap for those that can afford it, but I would argue that there is hope for a hybrid system. The issue is that those at the top have to be willing to fall to some degree to allow the whole system to rise. Having access to GOOD medical care should not be a privilege, it should be an option. That being said starting with small strides can make a large impact.

Many people believe cutting physician salaries and raising their taxes will help with healthcare costs, but have those people seen a surgical bill revealing what the physician has been paid vs what has been charged the insurance? Is it ethically sound to charge someone thousands of dollars for a procedure when the physician doing the work only gets a small fraction of that?

Starting small with something so simple as using the research we have on supplies such as the surgical bandages providing no long term protection against infection and improvement in wound healing. This was such an interesting point. Could we standardize supplies to ensure that all healthcare companies were provided the cheapest option on a product that still serves it’s purpose and meets a certain quality? Companies that are profiting off of inflated prices on healthcare equipment should be where we are looking to.