Rationing And Allocation Of Health Care

Having access to quality healthcare is major part of one’s life however the cost of care has been on the rise over the past decades and continue to rise every day due to many situation such

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

There are two main distribution principle regarding health care in the United States. The first being social justice, and the second being market justice. The delivery system has continued to undergo periodic changes, mainly in response to concerns with cost, access, and

The rationing of Healthcare in the United States exist in many different forms. According to the medical dictionary (2002), “Healthcare rationing is the limitation of access to or the equitable distribution of medical services, through various gatekeeper control.” Healthcare rationing takes place when a treatment is denied by a healthcare provider or insurance company. Patients that have access to private health insurance is rationed based on the prices of the services in which they receive and also their ability to pay. Insurance companies pre-screen applicants that are applying for health insurance for pre-existing medical conditions and at this time a decision is made to either decline the applicant or apply a higher price for additional medical coverage. Individuals that receive state insurance such as Medicaid is restricted by the applicants’ income and assets limits as well as other federal and state edibility regulations. According to Shi & Singh (2015), “ Although uninsurance among adults has increased, lack of health insurance coverage among children declined from 13.2% in 2009 to 6.5% in 2011 (CDC 2011a), mainly because of the success of the CHIP program.”

In healthcare system the highest quality medical care means” the greatest benefit to patients at the lowest possible cost” (Burke & Ryan, 2014, p. 3). “The Agency for Healthcare Research and Quality (AHRQ) defines quality health care as doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results” (NCQA, p. 3) According to American college of physicians, the single most reason for the health care cost is higher healthcare spending. There are several factors involved in the high health care cost such as inappropriate use of technologies, lack of patient centered care, overuse of the reimbursement, excessive price for health care facilities, increased organizational cost, and health accountability are some of the reasons for increased health care cost. In order to decrease the cost, the available health resources be used judiciously and equitably. Understanding these factors and identifying the potential factors of health care costs assists in providing quality and effective services and thus improves the health outcomes (ACP, 2009).

A challenge that the healthcare nation is facing is to provide the quality of care that is expected and obtain low healthcare cost. Working hand in hand with the private sector and government is in hopes of improving the quality of care that each patient deserves and maintaining the cost so that research can continue. The purpose of this paper is to look into relationships between healthcare cost and quality healthcare.

Moreover, the lack of access to health care is morally wrong because it is a fundamental right for humans to maintain self-dignity, fairness in the dispensing of health care, and the inclusion of all in society. Kantian’s ethical theory would argue that it is a moral duty to distribute health care more evenly so that the disadvantaged members of society have a similar chance at access to care. The consequence of those health disparities among the disadvantaged affects everyone’s quality of care and affects communities’ adversely. As a result, the cost shift from annual emergency room visits by the uninsured cost the public over $100,000 billion annually and as a result, distributes approximately an additional $1000 to each family’s insurance premium (Lachman, 2012)). Another example of distribution injustice is the unfair allocation of health care among race and gender. Studies have shown that there is a racial and gender bias in end stage renal failure patients, there is a disproportionate number of white males referred to transplant specialists as opposed to blacks and women. Additionally, their wait on the transplant list is longer, if they ever make it onto the waiting list (Beauchamp, 2013).

The primary ethical issue related to cost containment in health care is distributive justice. The reality of limited resources necessitates their allocation to yield the greatest good for the greatest number of participants. Finding the balance between provision of value in health care and cost containment remains a fundamental ethical challenge for health care reform. Ultimately, there should be effective ways to contain the already high and steadily increasing costs of health care, it will become more and more difficult to provide care in the current or in a reformed health care system (American College of Emergency Physicians ,

Health care economics involves making plenty of choices. Individuals, groups, businesses, and organizations choose how to use resources . Economics and health care are linked, because health care professionals apply economics in their everyday professional activities. They are able to do this through resource allocation. Any health care organization has to plan out how they will use their resources to their advantage. Health care economics are able to incorporate terms like cost, quality, and resources. In this paper, I will compare these terms as they relate to health care economics. In this paper, I will also explain how they

The philosophy relayed by the book’s author consistently leads back to the moral question that must be asked in the initial design of the healthcare system. That determination has to do as to whether the government has a duty to act when there are those within their own country do not have equitable access to hospitals and doctors for the treatment of their conditions.14

Steven Brill’s, America’s Bitter Pill, finds that there is a common theme among all factors of healthcare: access is restricted, the cost is unwarranted, and quality is disproportionate to the costs.

Rationing care consists of the ranked distribution of limited resources (Barr, 2011). In healthcare, the role of rationing care takes place when people acknowledge the unavoidability of restrictions on the extent of care that can be given and the need for ranking the care that is given (Barr, 2011). Rationing healthcare is the allocating of health care supplies and services based on cost (Barr, 2011). Disadvantages of rationing care involve ethical and moral issues that arise with having to make decisions about who would be best to make decisions and what treatments to ration (Barr, 2011). Unfortunately, in the United States, health care is rationed based on income (Barr, 2011). Advantages of rationing care are ensuring high quality care

Every day new technologies emerge with solutions to biological and medical issues. These solutions often involve social issues, and people are faced with decisions, for example, regarding reproductive rights, fetal stem cell research, and confidentiality with sensitive medical records. The impact of rising costs on the laws and the ethics of health care delivery the rising costs, both of health care insurance and of medical treatment in general, can lead to questions concerning access to health care services and the allocation of medical treatment. For example, should everyone, regardless of age or lifestyle, have the same access to scarce medical commodities such as transplant organs or highly expensive drugs? In today’s society, medical treatment and decisions surrounding health care have become complex. It is therefore important to be knowledgeable and aware of the issues and the laws that govern patient care. In order to understand medical law and ethics, it is helpful to understand the differences between laws and ethics. A law is defined as a rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority. Governments enact laws to keep society running smoothly and to control behavior that could threaten public safety. Ethics is considered a standard of behavior and a concept of right and wrong beyond what the

Decades ago Norman Daniels (Daniels 2000, Daniels 2001, Daniels and Sabin 2002) tried to answer questions that “How can we meet competing health care needs fairly under reasonable resource constraints?” and “Is there instead a fair process for making rationing decisions?” The questions challenged society that whether we knew the determinants of having health equity, do we have any solution to provide a fair process to distribute health resources equitably. From his study, Norman had developed a theory of accountability for reasonableness from the study’s results. The theory of accountability for reasonableness (A4R) (Daniels and Sabin 2008) has been discussed to be a process for decision making on health care priority setting (Daniels 2000,

In the present scenario achieving effective and efficient health care services is an acute issue that needs an immediate attention. In developing countries this problem is mostly common as the government alone is not fully capable in undertaking different challenges to meet the heath needs of fast growing populations. There was a need to develop an