Health Should Not Be a Privilege

I Am Infuriated And As a Social Worker I Should Be

I am infuriated. We live in a country where some of the leading causes of death, like heart disease, are largely preventable. Preventable. And yet the very systems designed to prevent illness remain inaccessible to so many people. Preventative care is treated like a privilege when it should be a right. From a clinical social work lens, this is not just frustrating. It is a systemic failure that contradicts our ethical commitment to social justice, dignity, and the worth of every person.

Access Is More Than Financial

Recently, I have been trying to take ownership of my health as an adult, navigating the healthcare system independently for the first time. What I have come to realize is that access to care is not just about money. It is about time, transportation, flexibility, knowledge, and power. These are resources that are not distributed equally. You cannot attend appointments if you cannot get off work. For many people, taking hours off for a single appointment is not feasible. It can mean lost income, disciplinary action, or even risking employment. The idea that people can simply go to the doctor ignores the reality of labor conditions that many individuals are navigating every day.

The Hidden Burden of Time and Transportation

Even when someone is able to attend an appointment, the system demands more. My recent experiences have involved spending hours between waiting, intake, and the actual appointment. When travel time is added, this can easily take up half a day. I am fortunate to have a car, which is a privilege in itself. For individuals relying on public transportation, that same appointment may require an entire day of planning and effort. This creates an additional barrier that often goes unacknowledged when we talk about healthcare access.

A Fragmented System That Discourages Care

The structure of care itself adds another layer of difficulty. Patients are often sent from one provider to another, each with separate systems, long wait times, and additional costs. Weeks turn into months. What is described as comprehensive care often feels like navigating a maze that requires persistence and resources. From a clinical perspective, these barriers are part of what we understand as social determinants of health. Healthcare access is shaped by employment policies, transportation systems, socioeconomic status, and systemic inequities. When individuals do not engage in preventative care, it is not a lack of motivation. It is often the result of structural exclusion.

The Privilege of Being Frustrated

There is also a reality that is uncomfortable to sit with. I am privileged enough to be frustrated and still receive care. That in itself is a privilege. Many people are not just frustrated by the system, they are shut out of it entirely. They delay care until symptoms become unbearable. They are forced to choose between medical bills and basic needs. They live with untreated conditions until prevention is no longer possible. By the time care is accessed, it is often too late or it results in overwhelming medical debt.

A Matter of Social Injustice

This is not an individual failure. It is systemic injustice. As social workers, we are trained to look beyond individual behaviors and examine the systems that shape outcomes. The healthcare system reinforces inequity and disproportionately impacts those who are already marginalized, including low income individuals, communities of color, people in rural areas, and those in unstable employment. We cannot talk about health without talking about power. Who has the flexibility to attend appointments. Who can afford to wait months for a specialist. Who can absorb the cost of continued care. And who cannot.

A Call to Ethical Action

The reality is that accessibility is not universal. It is stratified. When healthcare systems prioritize efficiency, profit, or bureaucracy over human need, the result is preventable harm. Preventative care becomes reactive care, and early intervention becomes crisis management. As clinicians, we witness the consequences of this every day through emotional distress, chronic stress, and compounded trauma. People are not dying because they do not care about their health. They are dying because access to care is conditional. And that should infuriate all of us.

Political Argument

High Quality of Care Does Not Mean Equitable Care

It is true that the United States offers world-class care in certain settings, particularly for complex or rare conditions. However, quality is not meaningful if it is not accessible. The question is not whether excellent care exists, but who can realistically obtain it. A system that produces exceptional outcomes for a small, resourced portion of the population while leaving others without basic preventative services cannot be considered high quality in an ethical or public health sense.

Innovation Should Not Come at the Cost of Access

The United States is a global leader in medical innovation, but innovation that is inaccessible does not translate into improved population health. Breakthrough medications and technologies are often priced in ways that place them out of reach for many individuals. If innovation widens disparities instead of reducing them, it reinforces inequity rather than solving it.

Shorter Wait Times Depend on Privilege

The argument that the U.S. has shorter wait times for specialized care overlooks a critical reality: this only applies to those who are insured, financially stable, and able to navigate the system. For many individuals, wait times are not measured in weeks, but in delayed or forgone care altogether. From a systems perspective, delayed preventative care often results in more severe health conditions later, increasing both human and financial costs.

Choice Is Limited by Structural Barriers

While the system is often framed as offering choice, this autonomy is heavily constrained by insurance networks, cost, transportation, and provider availability. The idea of choice assumes equal footing, which does not exist in practice. Many individuals must choose between affordability and continuity of care, or between receiving care and meeting basic needs. What is presented as freedom often functions as restricted options within structural limitations.