Conflicts Between Ethics and Obamacare / Trumpcare
The Patient Protection and Affordable Care Act (PPACA) was introduced by Obama to improve access to health care services and promote their quality, focusing primarily on adults aged between 19 and 64 years. It allowed more than 25 million previously uninsured persons to provide themselves with medical care. However, for those who do not receive subsidies from the state, the cost of insurance significantly increased. This model is characterized by the fact that a caregiver has the opportunity to offer an unnecessary procedure (Lenzer, 2012).
For example, a doctor could take a blood test, but he or she prefers to send patients to a laboratory, which he or she owns even if there is another laboratory next to the office, and it works more accurately. This is the so-called ethical conflict of interest. Approximately the same happens with many other tests and medicines. According to the recent study, doctors who have a share in the laboratory business are much more likely to prescribe unnecessary tests of magnetic resonance imaging (MRI) (Lenzer, 2012).
Presumably, it is this conflict of interest when a doctor first assigns an unnecessary expensive test and then gets paid for it, which serves as one of the factors in the growth of health care costs and Obamacare ineffectiveness. The excessive number of drugs and a large number of unnecessary procedures and operations, along with the denial of treatment due to the lack of health insurance, also cause the latter. Thus, PPACA created by Obama to ensure that all Americans have access to quality and inexpensive medicine increased the gap between residents with insurance and without one (Meyer, 2017). Some people go to doctors too often, and others do not go at all. At the same time, mortality rates consistently go up in both categories.
The situation in the national health care system is threatening and paradoxical. A vivid example is a recent case in Maryland when a group of doctors imposed patients with a good insurance on knee replacement (the average cost is $ 30,000). The investigation specified that out of 100 percent of the operations conducted less than four percent proved to be justified (Hsieh, 2014). It should be noted that several hundred people without insurance were begging to do their operations and break their cost into monthly payments. The similar unethical occasions occur throughout the country. The amount of insurance fraud has become so huge that some official departments do not even publish them. Since the introduction of Obamacare, the federals began to specify only the amounts that returned to the insurance system after inspections, fines, and criminal sentences.
Obama and the Democrats did not expect that medical reform would change the whole health care sector as they wanted to insure the additional 20 million Americans and keep the system in its original form. However, everything collapsed – neither the small medical offices, nor the giant pharmaceutical companies could not adapt to the reform. In his turn, Trump stressed the importance of access to insurance for all Americans who have a medical history. The new President suggested that when buying insurance, tax credits should be applied, and the volume of medical bills increased.
In addition, the reform should protect patients and doctors from unnecessary costs, which increase the price of insurance. According to Trump, it is important to give Americans the opportunity to buy insurance regardless of the state. More to the point, according to the new decree, heads of medical institutions should use their powers to cancel, postpone, or grant benefits of the provision of the health care law. The decree also instructs heads of relevant departments to promote the development of a free and open market for the provision of health and medical insurance services.
How Can Nurses Address Ethical Challenges?
The role of nurses as those who provides care directly to patients is great. To rectify the situation with unethical issues, it is necessary for them to serve as advocates for patients’ rights. Creating a robust culture of safety, nurses will ensure the high quality and necessary treatment. They are expected to double check the necessity of all the prescriptions made by a physician, thus minimizing the occurrence of fraud and any other unethical conduct. As noted by Argy (2017), nurses can “promote transparency in the reporting of medical errors so the profession and the public can get a clear picture of the problem we face together” (para. 8).
In particular, such measure as asking physicians about tests, medications, procedures, and other related issues is likely to provide more information on their performance and subsequently eliminate the existing ethical bias. The patient safety perspective should be assigned a top priority in terms of open communication and timely feedback (Argy, 2017). In their turn, in order not to become a victim of such a conflict, the patients should be especially attentive to what a doctor offers them and why he or she selects one or the other treatment option.
Argy, N. (2017). Forget ObamaCare v. TrumpCare, medical errors are the real challenge.
Hsieh, P. (2014, January 28). How ObamaCare creates ethical conflicts for physicians and how patients can protect themselves. Forbes.
Lenzer, J. (2012). Unnecessary care: Are doctors in denial and is profit driven healthcare to blame. BMJ, 345(1) 1-3.
Meyer, M. (2017). The ethics of universal health care in the United States. Reflections on Healthcare Management, 1(1), 10.