Medical Ethics and Health Care Policy Research Assignment (Essay Sample)

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Medical Ethics and Health Care Policy
Introduction
The challenge that employees and employers have is how much burden of the cost of healthcare is each one of them should bear (Berwick and Jama). The shifting of the cost of healthcare from company to employees has resulted in many dissenting reactions at Harvard. Even though reducing wastages may lead to price controls in healthcare spending, it is one of the fundamental strategies for scaling down the cost of healthcare and making it affordable to many. After going through the articles by Atul Gawande, It is apparent, healthcare systems may not have all the right information, they ignore evidence and that the most significant opportunity for cost reduction is to the complicated patients.
Healthcare Policy #1: Sharing Burden of Healthcare Costs
Employers are leaving a more significant chunk of the healthcare bill for care worker who uses their health insurance and benefits ((Berwick and Jama). Most companies and institutions such as Harvard, now offer health coverage that requires employers to pay yearly deductible. The size of such deductibles has increased in the past decade. To shore up the work-based health coverage system and cover the uninsured, employers need to contribute to the shared responsibility of healthcare costs. However, it is vital to comprehend that putting the too much medical burden to an employee may produce adverse outcomes such as demoralized and overburdened workforce.
Due to the rising cost of health insurance for both individual employees and families, putting more burdens on health costs for employees may lead to the withholding of medically essential care hence curtailing the usage of valuable services. Many companies forced to subsidize health coverage for employees may not be able to bear these rapidly increasing costs. Consequently, they will only offer medical services that are less expensive at the expense of the ones which are valuable but essential. Furthermore, the cost-sharing program will influence the health-seeking behavior of persons who over utilize or waste medical covers. Due to increase in the burden of healthcare costs, consumers will be more cautious in reducing wastages. On the contrary implementing cost-sharing programs may reduce Harvard employee medical costs since the employees are mandated to share the burden of their health care costs (Pear). More so, Harvard may decide to target subsidies and assistance to the poorest of the uninsured population.
Healthcare cost is may be shared in two ways, the first one is through premium contributions where the employer pays a share of the premium and the remainder deducted from employee’s pay check. Most insurance companies require employers to subsidize at least half of the premium cost for the covered employees. The second is cost-sharing at the point of service. Employees may pay a fixed amount at the time of service (co-payment), pay a flat amount before accessing the services (deductibles) or pay a given percentage after the services are billed (co-insurance). To minimize burden to employees, the greater the cost-sharing at the time of service, the lower the premium attached. More so, Out-of-Pocket limits should be set to protect employees from high costs. However, it should employers should be free to require employees to cater for some or all of the health premium costs for dependents.
The cost cutting instituted at Harvard is a pay cut and it is designed to come at the moment when you are sick. It is a pay cut because employees pay more for the healthcare services from their pockets. It is also shifts the financial burden onto the staff and faculty at the moment when they are most in need: when they fall sick. Therefore, it reduces the overall spending by Harvard but increases the overall spending by the employees. In as much as close to 160 million Americans receive healthcare coverage through employers sponsored programs; the cost of healthcare premiums have been rising (Brenner).The healthcare funding is a function of who the employer is. When one employer decides to change policies, it affects the healthcare benefits that were bargained. However, allowing employers to deliver health insurance has resulted to innovations driven by employees who see immediate return from high quality and lower-cost healthcare by paying bills directly. On the other hand, the national health insurance approach covers everyone, hence promotes inclusivity. Therefore, the better way for health insurance is a highbrid of national health insurance and Employer delivered health insurance.
Quality healthcare is a societal good. Employer-provided health care severely hinder the mobility and flexibility of the workforce and devotes significant company resources to matters that have nothing to do with the company mission. One of the ways of purchasing healthcare insurance is to tax employee health benefit to raise money for universal coverage. However, in the short-term, it will be costly for the employer and employee.
Healthcare Policy #2: Impact of Lobbying for Medicare Reimbursement on Healthcare
A lobbyist seeking to influence the U.S. federal government and state governments have gotten enormous attention from researchers, the public, and journalists (Blumenthal and Ryan). According to the Centre for Responsive Politics 2013, there are more than 12, 000 registered lobbyists spending over three billion dollars to try and influence the legislative process. Since lobbyist either uses persuasion to kill a bill or modify it in preferred ways, they may use their financial muscles to impact on legislative outcomes including those that may not be of public interest.
Since the government cannot adequately control how much each donor contributes, policy formulation process is becoming a hard task for those who do not have “enough” money since they may not be able to appeal to the lawmakers. Therefore, the question we may ask is, should political activists and lobbyists competing with “big” money have the monopoly on legislative processes? Policymaking should not be solely dominated by the “rich” since they may end up enacting legislation that only favors their interest at the expense of the better good of the majority “poor.” Legislation that are in public interest comply with applicable law, carry out functions impartially with professionalism and integrity, ensures proper accountability and act apolitically. Some lobbyists do not consider such aspects when lobbying.
Lobbying by Quality Home Nursing Care and Quality Home Healthcare for Medicare reimbursement on health may have both positive and negative effects. One of the most immediate adverse impacts on insurance companies is the decline in the number of people using medical insurance CITATION Pat15 \l 1033 (Patel). The reason for the reduction in health insurance uptake will be due to low costs of medical services as a result of reimbursements. However, if the reimbursements result in the decrease in insurance premiums, many persons will take health insurance premiums thus increase access and utilization of health services.
With more medical services insured, providers should expect an increase in utilization of healthcare services, including the “expensive” medical procedures (Collins). The increase in numbers of people seeking health services will not only boost revenues to healthcare providers but also increase the risk of overloading preferred healthcare facilities. Consequently, there may be the need to hire more staff and increase the capacity of health centers.
Healthcare Policy #3: Atul Gawande's Article and My Thoughts about Health Care Services
Health services exist to prevent, mitigate or eliminate suffering as a result of disease or illness. Therefore, there is need to implement strategies that improve the health of the society. After reading the article by Gawande, my thought about healthcare services is that, it is hard to ignore evidence and that the most significant opportunity for cost reduction is to the complicated patients.
The other factor is that it is hard to ignore facts and evidence on the part of the physician or doctor, especially if it is common knowledge among the healthcare practitioners. Data is imperative; with more data being accessible faster, the clinical conduct of physicians can change rapidly. In instances where physicians see how each one of them score or spend compared to their peers performing the same services, they may feel the urge to ensure their data is similar if not identical as the colleagues.
Moreover, after analyzing Gawande’s article, there is a notion that more evidence depicts that delivery and payment are working. In McAllen, Gawande found out that local clinical leaders using new health model were providing better healthcare and were more profitable CITATION Gaw09 \l 1033 (Gawande). Additionally, the medical group using alternative payment methods allowing physicians to share saving helped control health care costs CITATION Gaw09 \l 1033 (Gawande).
Furthermore, to reduce significant healthcare costs, the most notable opportunities are with the complicated patients. Chronic illnesses like hypertension and diabetes increase the likelihood of using more services and high-intensity procedures to manage the conditions. However, educating the patient on how to self-manage the disease can significantly reduce healthcare costs and demand for care.
As health insurance companies, the dilemma is in addressing the challenges of an aging population; reduce abuse of insurance by the insured while improving operational efficiency. Age comes with increased risk of illness and consequently increases in expenses for medication. More so, studies show that insured persons tend to over-utilize medical s...