Sep 10, 2009 -- This Point of View is written by Ruth Macklin, PhD, a professor in the Department of Epidemiology and Population Medicine and the Dr. Shoshanah Trachtenberg Frackman Faculty Scholar in Biomedical Ethics at Albert Einstein College of Medicine of Yeshiva University. She serves on the advisory board of the Center for Ethics at Yeshiva University and is the author of "Against Relativism: Cultural Diversity and the Search for Ethical Universals in Medicine" (Oxford University Press, 1999). In his speech to a joint session of Congress and to the nation on Wednesday, Sept. 9, President Obama quoted from a letter the late Senator Ted Kennedy had sent to him. Kennedy had written that health care is “above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.” Kennedy got that right, and President Obama was wise to cite the moral necessity of ensuring that all Americans are guaranteed an adequate level of health care by some mechanism or other. What that mechanism will be is a matter to be hammered out in the political process. However, the President was also wise to insist that he “will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it.” Health care reform means different things to different people—lowering costs, ensuring universal coverage, limiting the power of insurance companies to deny coverage for pre-existing conditions, reining in medical malpractice lawsuits. President Obama mentioned all of these in his speech—a politically necessary maneuver if he is to obtain the needed support from Congress. But it is chiefly the universal coverage that is the moral issue, along with making sure that insurance companies do not deny coverage for certain conditions, refuse to renew a policy or place a lifetime cap on an individual’s insurance costs. Unlike every other industrialized nation, the United States has never recognized a “right to health care.” Although a single-payer system would almost certainly be less costly and administratively simpler than the unwieldy array of multiple insurers, the key ethical issue remains that of guaranteeing that everyone in this wealthy nation receives needed preventive and therapeutic medical care. Yeshiva University is not responsible for the content of this article. The opinions expressed are solely those of the author and should not be attributed to Yeshiva University. Want to learn more about the ethics of health care reform? Attend the Center for Ethics’ panel discussion on “Health Care Reform: Ethics of Public Policy, Ethics of Public Debate” on Oct. 25 at 6:30 p.m.