Ethical Responsibilities in Healthcare
It is a well known fact that the United States healthcare system is one of the most inefficient among the advanced economies. Despite being the leading economic power, its ranks below Scandinavian countries Denmark, Norway and Sweden and Western European countries such as France, Britain and Germany in terms of costs incurred, health outcomes, etc. This is a clear indication that the predominant role played by private business corporations (in the form of hospitals and insurance companies) has hampered our healthcare system from meeting its full potential. In a well-functioning system, the private involvement will be limited to the extent that it brings efficiency and innovation to the system. The lack of such checks on private ownership here in the United States has significantly reduced access to quality healthcare to many disadvantaged groups in the population. For example, it is believed that close to 50 million Americans do not have any health insurance to fall back on. This compares unfavorably with more equitable and socially engineered healthcare systems of Scandinavia and Western Europe. (Mann, 2007, p.6)
As it functions today, the health care policy framework designed to ensure sustained profitability of insurance companies, private hospitals, etc. This condition should alter radically and the emphasis should be laid on meeting the health-care needs of patients. In other words, an ethical healthcare system should put people’s healthcare needs above corporate profits. Even the recently passed healthcare reform legislations do not address core issues head-on; rather they only try to tinker with and correct a few aspects of a deeply flawed system. Hence, the adoption of a social-democratic policy framework is essential in order to favorably turn the situation around. The successful examples are already there; what is required is the requisite political will.
Medicare and Medicaid are two prominent public healthcare programs that come under the purview of the Federal government (with some autonomy given to states) and are funded through taxpayer money. But these programs do not solve all the prevailing problems in American healthcare today. Both these programs came into effect when Lyndon Johnson Administration made amendments to the Social Security Act in 1965. The Medicare program is intended to cater to the healthcare needs of senior American citizens as well as disabled persons. There are four main parts that constitute the program. Part A and Part B cover hospital and medical insurance respectively; Part C offers flexibility whereas Part D covers cost of Prescription drugs. The Medicaid program, on the other hand was created to take care of the healthcare needs of those who are economically disadvantaged, but exceptions are made for special cases and circumstances. Put together, these two public healthcare programs give coverage to about 80 million American citizens, whereas the total population is more than 300 million. Moreover, the coverage extended by the two programs are for well-established medical conditions and well-entrenched treatments and procedures, thereby denying support for those patients who resort to emerging and innovative treatment regimes. Although these programs cost the federal government close to $800 billion and comprise 5.6 %of the nation’s GDP, they cover less than a third of the population and that too only for select medical conditions and treatments. Hence, provisions for universal healthcare coverage under these two programs should be the ideal toward which the nation’s leaders should aspire. (Bodenheimer, 2008, p.798)
Another major worry here is the fact that the high costs of healthcare in the United States do not necessarily buy the best health care services. The chief concern for corporations like GM and Ford is the ever growing healthcare costs and massive healthcare liabilities. A recent trend has been for major industrial corporations to shift their bases across the border to Canada, where the government provides better support for employee health insurance. There is also a push for healthcare reform to mimic the Canadian system. In fact, under Bill Clinton, such a move was aborted in the last minute due to pressure from insurance and pharmaceutical companies. It is widely agreed that the current crisis in the US health care system is due to higher prices for pharmaceuticals, physicians and hospital care. Although there is consensus among policy makers as to what should be done to alleviate this problem, the required political will seems to be lacking. Rather than trying to reduce prices, attempts have been made by politicians to reduce access to healthcare and service consumption (Tepper & Terry, 2004, p.69). Even with the current estimates on projected Medicare and Medicaid savings, as well as savings from capping deductions for the rich, there is bound to be a “potential shortage of $300 billion to $600 billion of additional revenue because most estimates of 10-year cost of full coverage are in the range of $1.2 billion to $1.5 billion (with some estimates being as high as $2 billion)” (Webster, 2006, p.102). But we have to remember that a deficit of $300 to $600 billion over a ten year time frame pales in comparison to the $700 billion bailout that was handed to the failed financial institutions of our country. Surely, there is something sinister about our economic system, when privately owned and run banks are given preference over the health and wellbeing of millions of citizens.
It is quite clear from the issues discussed above that the healthcare system has to be reformed. In the following concluding remarks, a brief summary as well as some constructive suggestions for reform would be outlaid. As was discussed in the main article, corporate influence over the healthcare industry is a major problem. One of the tasks facing leaders in the industry is the reduction of corporate influence over democratic institutions and political processes. This influence is reflected in the choice of staff members in the executive branch of government, the handpicked appointments to posts in judiciary, the corporate funding of candidates during election campaigns, etc. It is both ironic and improper that the reason healthcare reform became an election issue last year was because of pressure from large business corporations such as GM and Walmart to alleviate their expenditure toward employee health insurance (Richmond & Fein, 2007). This suggests that legislative changes take place in our country only when one or other of the corporate groups will the government to make favorable changes. It then begs questions about the nature of our democratic institutions and whether or not we have a functioning democracy in the first place.
It was also identified in the paper above that the healthcare industry suffers from a lack of fresh ideas. It is then imperative that healthcare industry leaders heed to fresh viewpoints as expressed by noted documentary filmmakers such as Michael Moore, as well as prominent left-wing intellectuals like Howard Zinn, Noam Chomsky, Paul Krugman, etc. According to these alternative voices of reason, meaningful progress, in healthcare or in other aspects of society and economy, will not come about, until we address the broader systemic flaws. Only by embracing some radical policy alternatives can a semblance of ethics be brought into our ailing healthcare system. (Krugman, 2009)
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