NUR 621 Topic 2 Discussion
DQ: What are the ethical implications of distributing scarce resources?
Uninsured patients can negatively impact the financial status of health care organizations. Uninsured people tend to put off medical treatment and visits and preventative care screenings and treatments. These individuals are sometimes more likely to develop chronic conditions such as high blood pressure, diabetes, cancer, obesity, and heart disease, which can burden the health care system by higher mortality and morbidity rates and readmissions to healthcare organizations and increasing healthcare costs. Some organizations provide a healthcare safety net or charity care for the uninsured; however, there might be limited services and resources or limited access to such facilities (Garfield et al., 2019). Limited healthcare services and resources might lead to poorer patient outcomes. Healthcare providers should aim to always provide the best care to all people, which might cost healthcare organizations significantly due to the lack of revenues from uninsured patients.
Despite the negative impacts lack of health insurance can cause a healthcare facility, all patients should receive high quality, exceptional care all the time. “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, race, religion, political belief, economic or social condition” (WHO, 2017). Healthcare organizations and providers should not be biased when providing care. This writer’s world view is to treat others the way you would like to be treated; this writer would want the best care despite health insurance status. Lack of care could be a thin line between life and death. A business needs to balance cost, and this issue does come with its challenges, but it should not be that balancing cost out ways the provision of safe quality care for all.
Ethics plays a significant role in healthcare and healthcare delivery. Beneficence, justice, autonomy, and non-maleficence are generally the four ethical guiding principles that guide healthcare delivery (Rawlings et al., 2020). The two principles that stand out for this
writer regarding the situation of scarce resource allocation are beneficence which is acting in the best interest of and promoting the well-being of others, and justice which is treating people fairly (Rawlings et al., 2020). Nurses have ethical principles that guide nursing practice. The two provisions from the code of ethics that stands out for this writer regarding the above situation are that nurses have the authority, accountability, and responsibility for nursing practice, and decisions and actions should be consistent with optimal patient care; and that nurses through individual and collective efforts should establish, maintain, and improve the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care (Gaines, 2021).
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References
Gaines, K. (2021). What is the nursing code of ethics? https://nurse.org/education/nursing-code-of-ethics/
Garfield, R., Orgera, K. & Damico, A. The uninsured and the ACA: A primer- key facts about health insurance and the uninsured amidst changes to the Affordable Care Act. Kaiser Family Foundation. https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-heatlh-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-does-lack-of-insurance-affect-access-to-care/
Rawlings, A., Brandt, L., Ferreres, A., Asbun, H. & Shadduck, P. (2020). Ethical considerations for allocation of scarce resources and alterations in surgical care during a pandemic. Surgical Endoscopy, 1-6. https://www.ncbinlm.nih.gov/pmc/articles/PMC7216853
World Health Organization (WHO). (2017). Health is a fundamental human right. https://www.who/int/news-room/commentaries/detail/health-is-the-fundamental-human-right
Knowledge Check:
Identify two impacts of the uninsured on the health care system. What systems are in place to manage these costs?
Hello Professor Hale and class,
Two impacts of the uninsured on the health care system is lack of health insurance has implications for health and mortality. People who are uninsured face financial as well as medical health risks. Most uninsured patients go to the emergency rooms because they lack medical coverage and need to be seen. “They often are more likely to delay or forgo preventive care.” (Penner, 2017) This in turn puts a huge strain on the Emergency Departments and their budget. In addition the price of insurance increases to offset the debt. The problems of the uninsured may lead to inefficiencies and higher costs of care. “The implementation of the ACA has reduced the number of uninsured, thus helping to reduce access problems and resulting poor health outcomes.” (Penner, 2017) Also, Medicare and Medicaid aid in managing the cost of the uninsured.
Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). Springer Publishing Company.
REPLY
The United States has experienced a significant shift in the number of uninsured people over the last 10 years. There were 28 million nonelderly people uninsured in 2016 with an increase to 30 million in the first half of 2020 (Finegold, et.al., 2021). At the start of the ACA in 2010, there was a significant increase in coverage, especially for minority population. Despite this there are still large racial and ethnic disparities. The increase in coverage was quickly impacted by the COVID pandemic. A survey conducted by the U.S Census Bureau in 2020 and 2021 suggests a 22% decrease in coverage. Although there was a decrease in the number of people insured in was not as significant as the National Health Interview Survey originally anticipated (Finegold, et.al., 2021).