People talk about 'commodification' in medicine as if it's always a terrible thing, but it's not; being viewed as a commodity is not always a bad thing.
A commodity is an item produced for sale and valued because of its utility to the consumer. Price, cost, distribution, and availability are determined by free market processes, which are governed by limited government controls. Medicine/healthcare, on the other hand, refers to the provision of aid to persons in need of cure and care by other experts who have the necessary expertise and knowledge. Therefore, in health care, the essential feature is the personal relationship that exists between the individual seeking assistance and the healthcare professional. In this regard, it is for this reason that the paper argues that there is nothing wrong with treating health care as a commodity.
Commodification
Principally, there is no problem with the argument that there are specific services or goods that should not be treated as a commodity. There are two principal cases where this claim is justifiable. The first argument entails the observation that specific kinds of goods are so closely related to people's integrity that selling and buying them is not consistent with human dignity. These types of items are by their very nature unsuitable for trade. Moreover, market creation for them establishes perverse incentives, which violate the integrity of persons. Thus, this is the reason people do not sell and buy transplant organs, and why most people are convinced that surrogate motherhood contracts should not be allowed among other medical procedures. Nevertheless, there has never been a case of anyone complaining that there is something utterly wrong with selling and purchasing health care services, or that it defies human dignity when the services are bought or sold. The common problem in most instances is the refusal to provide such services that provokes anger.
The second argument is much more essential because it relates to moral incentives. Notably, it has been viewed that in many cases, moral incentives help in securing a higher level of provision of a particular good as compared to commercial ones. Since market creation tends to foster self-interested behavior, commodification has the power to affect provoking collective action issues, and thus minimizing the efficiency of a particular sector. Such dynamic is well described in the Richard Titmuss study on the supply of blood. He argues that a system of voluntary blood donation attracts more donors than people who get paid to donate their blood.
Therefore, when evaluated literally, the argument that healthcare should not be treated as a commodity is feeble. Concerning the police force analogy, there is no doubt that personal security is a fundamental human right in the community and not a commodity. However, no one has ever made a suggestion that those people with the resources should be barred from selling them. Additionally, there is a growing private security services sector that operates alongside the public sector. Hence, the simple fact that something is right does not mean that it cannot become a commodity, especially in instances where there are individuals with a desire and the resources to consume more of it than the general public. Therefore, there is nothing wrong with the idea of abortion or surrogate motherhood because those with the resources can purchase the commodities, which will bring additional happiness to their lives.
Surrogate motherhood
Most people who go against the medical practice of surrogate motherhood argue that children are treated as commodities, and this should not be the case. Kids are considered as items in cases where the surrogate mother falls prey to concerns of eugenics. Typically, contracts of surrogate motherhood have clauses that demand the fetus to undergo genetic tests. The contracts also state that the surrogate mother should abort the fetus in case the child fails to pass these tests (Pence, 1977). Moreover, the genetic counseling clinics are encountering a dilemma because the tests that disclose if the fetus is suffering from certain genetic defects also reveal the sex of the child. Hence, when a mother aborts a normal child because the contracting parents desire children of a particular sex is one way of looking at kids as commodities (Krimmel, 2000, p.37).
However, these and other evils of similar stature can take place whether or not law permits surrogate motherhood. Nonetheless, this discussion does not support that children are treated as items to the extent that a particular sex continually gets aborted. The thing is, there is no problem with people striving to better themselves as long as their efforts do not lead to intolerance to things that are not perfect (Krimmel, 2000, p.38). Besides, what is the problem with people with resources wanting to get a child so that they can maintain their marital happiness?
Reproduction via surrogate motherhood deviates from cultural reproduction norms, and hence, it seems wrong and immoral to many people. The truth is surrogate motherhood and commodification of children may be beneficial for all the involved parties. Since surrogate contracts satisfy the desire of a wife and husband enabling them to bring up a child that is healthy and more certainly a baby with the genes of one partner. Further, the need for surrogate motherhood arises when a wife suffers from a sex-linked genetic disorder or a dominant autosomal such as hemophilia. Another reason would be infertility, and the couples possess a strong desire to get children. A good number of infertile couples endure endless marital conflicts due to lack of the ability to bear children. Also, such couples are filled with self-doubt and anguish. Therefore, if surrogate motherhood is the only way to bring happiness to such couples, then the commodification children or medical practice of surrogacy is not such a bad thing (Robertson, 2000, p.29).
Equality in the distribution of medicine
Most people who are against the idea of commodification of medicine argue that health care should not be treated as a commodity; instead, they suggest that it should be distributed according to need and not the paying ability. Therefore, the argument is not that there is anything intrinsic to healthcare that makes it unsuitable for sale and purchase. The underlying rationale is an array of fundamental concerns of distribution. Hence, if justice on distribution is the issue, then there is something unclearly demagogic about the contention of commodification. After all, there is a consensus (reasonably widespread) among empirical analysts that states with access to healthcare in the country have become equal than it was in the last quarter century. Therefore, the issue should not be about equality in healthcare opportunities, but it should be on whether such balance will persist or not (Gutmann, 2000, p.542).
Nevertheless, it would be impossible to expect that all people will be willing to undergo the same type of medical procedures, especially when some people are wealthy enough to afford more expensive services. Mainly, several concerned healthcare providers today acknowledge that the advanced medical provision has cajoled more Medicare services than the government can deliver to every single person. The country has more need for medicine than the resources to actualize it. Thus, this is one of the reasons the healthcare system, status quo cannot be sustained (Lamm, 1993, p.14). Hence, no modern society can afford to provide all the "beneficial" health care, and this is promoting the success of the private medical system, meaning that for the government to provide all the required health services, the private sector is essential.
Commodification violates medical core values
Some critics argue that establishing the market competition benefit for healthcare, when it is treated as a commodity, may destroy professionalism. Trust and confidence are essential for the stable personal and continuing relationship between a doctor and patient. Moreover, human health is basic for individuals to thrive, which is one of the reasons it should not be treated as a commodity. According to market/business ethics, emphases are placed on expenses being less than the revenues. Additionally, when patients are seen as commodities, then they are weighed as centers of either loss or profit. Moreover, in market ethics, the pursuit of self-interest and profit-making are legitimized and if applied in healthcare, they lead to inequality in the distribution of treatments and services, which is unfortunate, but not unjust.
Medical professionals have a code of ethics that they are supposed to observe, and the code most affected by commodification patients are beneficence, justice, respecting patients autonomy, and non-maleficence. The principle of justice provides that patients in the situations that are similar should be given the same care. Moreover, when people are at their most vulnerable conditions, they require additional protection than the business ethics can provide. In contrast, Gutmann (2000, p. 535) argues that the idea of respecting the autonomy of patients and being just should not be a problem because patients will receive health care for the services they pay for, the two-tier class system. Therefore, there will be no room for unjust treatment due to commodification since you receive the care for the service paid for.
Conclusion
From the above arguments, it is clear that commodification of medical services is not always a bad thing. Precisely, it only becomes unethical when the needy patients fail to get services. However, if they can access affordable services, then there is nothing wrong if the affluent patients want to purchase more superior healthcare services. Moreover, commodification creates room for medicine to be viewed as an item used to increase the level of happiness. Hence, there is nothing wrong if individuals want to purchase an additional private security to ascertain their safety. In this regard, there should not be a problem when it comes to buying additional healthcare.
References
Gutmann, A. (2000). For and Against Equal Access to Healthcare. In G. E. Pence, Classic works in Medical Ethics: Core Philosophical Reading (pp. 542-560). Michigan: McGraw-Hill.
Krimmel, H. T. (2000). The Case against Surrogate Parenting. In G. E. Pence, Classic Works in Medical Ethics: Core Philosophical Reading (pp. 35-39). Michigan: McGraw-Hill.
Lamm, R. D. (1993). Saint Martin of Tours and the New World of Public Policy. The Humanist, 13-15.
Pence, G. E. (1997). Classic works in medical ethics: core philosophical readings. Michigan: McGraw-Hill
Robertson, J. A. (2000). Surrogate Mothers: Not So Novel after All. In G. E. Pence, Classic Works in Medical Ethics: Core Philosophical Reading (pp. 28-34). Michigan: McGraw Hill.
