The Ethical Dilemma Posed by Medical Treatment, Essay Example

The ethical dilemma posed by medical treatment for the uninsured runs deep, and can be evidenced in different manifestations such as the current public debate over healthcare.  In an ideal world, those in the medical profession would treat and serve everyone, and those patients would in turn be prepared to compensate for the time and expertise give.  But, sadly, we do not live in an ideal world.  And in this murky world of reality, with the needs of an industry as well as the patient, it becomes increasing difficult to find where to draw the delicate lines as to who to help, how to help, when to prioritize and where the power comes from to decide.  On one end of the spectrum of beliefs is the practice of denying treatment for those patients unable to pay a significant full fee upfront; a pattern often combined with the charging patients a higher rate than third party payers. (Gapenski, 2006) Proponents of these measures cite the overwhelmed and comparatively ineffective nature of state run institutions, and make the plausible argument that without sufficient funds coming in services would suffer unfairly for all patients.  Others feel that quality healthcare is a universal human right that should not be jeopardized in any way by a patient’s ability to pay.  Under these set of beliefs, “Basic healthcare is a right, and if necessary, the government should allocate more resources to assure everyone access to basic healthcare services.” (Cunningham, 1989)  Those who agree with these principles frequently oppose aggressive debt collection for medical bills.

A number of practical, middle-ground solutions, or pieces of solutions, have been circulating with some measure of popularity.  Some focus on uninsured loopholes, such as closing the window foreign nationals who do have access to money to abuse government and charitable assistance programs.  Others look at a larger restructuring and cost-cutting measures within the medical field.  (Jha, Chan, Franz, Bates, 2009)  By finding ways to reduce the cost of healthcare without adversely effecting quality of service, proponents of this plan say the burden of the uninsured and delinquent payers becomes greatly reduced.  There is even a field of thought that all those unable to pay for services should be provided for not by the medical community of the government but by the goodwill of non-profit healthcare facilities.  While this would certainly simplify the issue, the reality of funding in the non-profit sector is such that all the uninsured would simply not have many of their healthcare needs met.  One of the simplest ideas for facilitating the uneasy relation between the uninsured and the providers is to charge the patient the same rate as is charged to the insurance company.  Many feel this is unfair, due to the fact that the insurance companies have carefully negotiated these rates for their own clientele, but the reality is that this is a price in which the provider has already agreed that they can run their facility and turn a profit.

Perhaps the best solution to the problem would be to take each provider on a case-by-case basis.  By looking at the profit margins at any given facility, it can be determined how much assistance would break-the-bank and how many of the delinquent bills are essential for the facility to re-coup.  Only by looking at this data, and making a careful analysis of an institutions individual situation, can one hope to have enough data to make these decisions.  Otherwise, its all theoretical argument; which of course there is a valuable place for, but not when it comes to the real healthcare services of real people.

References

Gapenski, L. C. (2006). Cases in healthcare finance (3rd ed.). Chicago: FACHE/Health Administration Press.

Jha, A., Chan, D., Ridgway, A., Franz, C., & Bates, D.. (2009). Improving Safety And Eliminating Redundant Tests: Cutting Costs In U.S. Hospitals. Health Affairs, 28(5), 1475-1484. Retrieved October 20, 2009, from ABI/INFORM Global.

Cunningham, L. (1989). The Will of the People. (pp. 21-24). Retrieved July 15, 2009, from Healthcare Forum Journal.