Sustainable and accessible healthcare and the common good

Abstract

Health is a major unifying issue of life and the debate on sustainable healthcare centres on the dichotomy of the rights of a person to access healthcare, and the limited resources a community can provide to ensure availability of this healthcare. It has been proposed that the way in which different communities deal with the allocation of healthcare, depends on the moral self-understanding in that community and its understanding of the concept of the Common Good. The historical understanding of the Common Good within the Catholic Church's Social Teaching, affirms how this concept is essential to integral human dignity. In this review it will be shown how, despite critiques, the understanding of concepts such as distributive justice, solidarity and subsidiarity in the Common Good are still extremely relevant in today's secular society. The discussion will be contextualised by the assessment the various healthcare systems present in today's pluralistic societies in Europe and the US, as well as in developing countries and emerging economies. The provision of healthcare in Malta will be used as a case study to illustrate how the principles of the Common Good, such as accessibility and sustainability, are being ascertained or otherwise in practice by means of strategies being developed by regulators, healthcare providers and other stakeholders. Many common denominators underline several of these strategies such as ensuring equitable access and reduction of health inequalities, reduction in waiting times, and seeking quality in service provision and delivery. Recommendations will be given on basing these strategies for the Common Good in healthcare on covenants (rather than contracts) based on trust, whilst recognizing the interaction of multiple factors operating simultaneously in health seeking behaviour. The Common Good which is person-centred is the basis which will result in a real dynamic change in ensuring a sustainable and accessible healthcare.