A Fundamental Right of the Monied to 'Buy Out Of' Universal Health Care Program Restrictions Versus the Moral Claim of Everyone Else to Decent Health Care: An Unremitting Paradox of Health Care Reform?
Bibliographic record
Abstract
A consensus has emerged that we should move toward and then achieve universal health care coverage. Reaching out to the 47 million presently uninsured will require significant restrictions on care within and without a universal plan. The most direct form of limitation on wealthier individuals seeking care outside a plan - one followed in Canada, a recently vetoed California plan, and in the Clinton plan - is to prohibit supplemental insurance. This article advocates a plan that incorporates such a limitation and associated restrictions. Any such restrictions are likely to be met with constitutional objections. For example, in 2005 Canada's Supreme Court found Quebec's prohibition on supplemental insurance unconstitutional. A finding that there is a fundamental right to purchase care, such as made in a 2006 federal appeals court ruling concerning experimental treatment, augurs problems for an array of health care reforms. This article will establish that although there is a fundamental right to purchase care, it is limited to care that the government has released for general use or sale. It does not include experimental care, treatments (such as marijuana) the government subjects to criminal prohibition, or interventions that the government has determined to be otherwise inefficient or immoral (e.g., transplantation requiring purchased organs). Therefore, although a properly cabined fundamental right to purchase care can limit universal health care reform if it incorporates irrational restrictions or does not deliver what it promises, such a right does not threaten a plan even as restrictive as the one advocated here.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".