The United States ranks high when it comes to health inequality, coming in third behind Chile and Portugal, according to a recent study.

Medical ethicist Art Caplan joined BPR to explain why the gulf between rich and poor in the U.S. is not just unfair, but also unethical.

“To me, health care is a right. It’s a right because you can't function in a competitive free market society without minimal health,” he said. “If you can’t walk, if you can’t sleep, if you can’t do physical functions, if you need assistance, if you're too sick and bed bound, then you can’t have equal opportunity.”

Caplan called it a “key and obvious moral point of justice” that there shouldn’t be differences in access to healthcare for rich and poor Americans.

“To be fair, we have had this for a long time, through many administrations,” he said. “The ACA helped; Trump’s policy will reverse that, particularly slashing funding for Medicaid, which will increase disparities, not help.”

Caplan said he was not optimistic about Congress letting this news affect its policies.

“Is Congress going to care? Well, already they’re indicating they don’t care by trying to knock these people off the Medicaid rolls,” he said.

Caplan said New York, Nevada and California have already floated policies that would lessen the disparity in access between rich and poor. He predicted that other states will probably pick up the burden to insure their citizens, since the federal government is unlikely to change its tune.

“No, I don’t think Congress gives a hoot,” he said. “They seem hell-bent on saving money, and they don’t seem to care about health.”

Art Caplan is the Drs. William F. and Virginia Connolly Mitty Chair, and director of the Division of Medical Ethics at NYU Langone Medical Center. He’s also the co-host of the everyday ethics podcast. To hear his interview in its entirety, click on the audio player above.