A debate concerns the enactment and implementation of a single-payer health system continues to be the subject of contention in the United States. The issue has been opposed and supported in an almost equal measure. In the single-payer system, the government tasks one of its agencies to collect insurance premiums and then reimburse health care providers for their services. The United States health care system functions using the multi-payer health care system, where individuals or their employers pay health insurance at different limits coverage who then reimburse service providers. The focus of this paper is to analyze the public health policy from an ethical perspective by evaluating ethical dimensions and justifying one public health action.
Analysis of the Ethical Issue
What are the public health goals?
According to Graves (2017), the public health goals of the single payer system is to provide universal coverage to health care, reduce wasteful spending, and eliminate the profit motive in health care. The goals of the policy are also to reduce the amounts paid in the form of health care premiums and improve the quality of care. What are the public health risks?
According to Platt (2017), perhaps the biggest public health risk of implementing the single-payer system is eliminating the opportunity for innovation. Since the system eliminates competition, it, therefore, eliminates the need for innovation. It, therefore, means that innovation that may be used in saving lives may not be pursued. What are the ethical conflicts and competing moral claims of the stakeholders?
Some of the competing moral claims of stakeholders on the issue are that taxes will increase regardless of how much an individual uses the health services. Another competing moral claim is that individual freedom of choice of how he or she accesses health care will be limited. Is the scope of authority in question?
The federal government through the Congress have the power to ratify a law that will require that a single-payer health system is implemented. Congress can designate one government agency that will collect premiums and make reimbursements. Are there relevant laws or regulations?
At the moment, there are no laws that support the single payer system in the United States. Is there a precedent case?
An example of a country that has set a precedent in enacting a single-payer system is Canada. According to Martin and Guerra (2017), in Canada, health insurance premiums are paid through a public plan, and the private sector provides medical services. Is there a professional code of ethics? According to Sade (2013), a professional code exists that states that medical practitioner should provide care to a patient at a reasonable cost to increase access.
Evaluation of Ethical Dimensions
According to Mill (2016), the ethics of utility state that the best course of action is one that maximizes utility. The application of the ethics of utility to the single payer debate results in the position that the single-payer system being better than the multi-payer system. The reason is the insurance premiums will be utilized at a maximum level when paid through a public policy that ensures universal access than through a privatized system. Justice
Souryal (2014).states that ethics of justice seeks to provide a solution that harms the least number of people. In the debate on which medical service reimbursement is suitable, having a single-payer system will provide a solution to accessing health care that will harm fewer people. If the multi-payer system is chosen, it will mean that a large proportion of the population will not get access to the services hence exposing a large number of people to harm.
Respect for liberty
Respect for liberty requires that people are allowed to undertake their individual choices and preferences. A multi-payer system provides patients with more flexibility and the ability to receive a customized service. On the contrary, the single-payer system creates uniformity and little room for variation to cater for individual choice. Therefore, using the ethical perspective of respect for liberty, a multi-payer system would be preferred. Respect for legitimate public institutions
The ethical dimension that calls for the respect of legitimate public institutions implies that they should be allowed to operate on their own without interference from the government. By introducing the single-payer system, the government will be interfering with a system that has existed for a long time, therefore, bringing about disruptions. Consequently, it would be preferred that the single-payer health care system is not ratified so as not to bring disruptions.
Justification of a Particular Health Action
Regardless of the different ethical dimensions, there is health action that is justifiably better than the other is. The particular health action is that the government should implement the single-payer system in healthcare. The rationale for the position is that it is effective in reducing the cost of accessing health care through payment of high rates of premiums since for-profit intermediaries are eliminated. Secondly, the proportion of benefits from the implementation of the policy is greater than the ramifications since a greater fraction of the population will now have access to health care services.
Thirdly, the policy is a necessity since the cost of medication keeps on raising, it locks out uninsured persons from the ability to access quality health care. It is, therefore, a necessity for families in the low-income brackets. Fourth, the policy creates a sense of impartiality since it allows uniformity in accessing health care services. Uniformity can be manifested in the manner in which there will be universal coverage and therefore equal access to all. There will also be equal access to necessary medical procedures without variations in costs. Lastly, the implementation of the policy will have the least infringement on persons who could afford private insurance covers. The reason is that a majority rather than a minority of the population cannot afford medical insurance. Hence, infringement will occur in the situation where the few who can afford will be paying higher taxes, which will be used to support the welfare of the many who cannot afford the service.
Though the use of a single-payer health system continues to be the subject of contention in the United States, it appears to be the most ethically sound approach toward increasing access to health services. The reason is that the proportion of benefits from the implementation of the policy is greater than the ramification and that infringement will occur at minimal levels. Also, the policy creates a sense of impartiality since it allows uniformity in accessing health care services.
Graves, S. (2017). Single-Payer Health Care in California: Goals and Challenges. California Budget And Policy Center, 1-5. Retrieved from https://calbudgetcenter.org/wp-content/uploads/Courage-Campaign_Scott-Graves_9.19.2017.pdf
Martin, M., & Guerra, D. (2017). A Canadian Doctor Explains How Her Country's Single-Payer Health Care System Works. Retrieved from https://www.npr.org/2017/09/24/553336111/a-canadian-doctor-explains-how-her-countrys-single-payer-health-care-system-work
Martin, M., & Guerra, D. (2017). NPR Choice page. Retrieved from https://www.npr.org/2017/09/24/553336111/a-canadian-doctor-explains-how-her-countrys-single-payer-health-care-system-work
Mill, J. S. (2016). Utilitarianism. In Seven Masterpieces of Philosophy (pp. 337-383). Routledge.Platt, M. (2017). The Dangers of Single-Payer Healthcare. Retrieved from https://www.cagw.org/thewastewatcher/dangers-single-payer-healthcare
Sade, R. M. (2013). Are surgeons ethically obligated to treat Medicare patients despite substantial reductions in reimbursement? Introduction. The Journal of thoracic and cardiovascular surgery, 145(1), 37.
Souryal, S. S. (2014). Ethics in criminal justice: In search of the truth. Routledge.
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