respond to the following as a peer, The U.S. has one of the most expensive healthcare systems in the world, with 2018 data demonstrating per capita national health care expenditures at $11,172, totaling $3.6 trillion in spending and comprising 17.7% of the gross domestic product (GDP) (CDC, 2021). According to AARP, 15% of the U.S. population depends on Medicare for health care. The proportion of individuals dependent on public resources for health care coverage rises for those over 65 (94.1%), as household income falls (less than $25,000, 71.2%), and with more limited completion of education (no high school diploma 36.9%) (USA, 2020). Factoring in the rapidly growing population and rising cost of care, the U.S. must make tough decisions on the availability of health care for its citizens.
Regardless of a patientâ€™s source of insurance coverage, the patient has the right for autonomous decision making based on adequate informed consent which includes the options available and risks and benefits of each. For example, in counselling a patient regarding a surgical procedure, the healthcare provider should present the patient with all the options for their problem, including the risks and benefits of each option, and allow the patient to make their decision, regardless of insurance type. A patient must be offered all options for the procedure, especially those that are the safest, regardless of the cost, important under the principle of nonmaleficence (Pozgar, 2020). Justice requires fairness in the distribution of benefits and risks (Pozgar, 2020). Despite the above stratification of populations, based on age, economics, and education, into commercial vs. public insurance, justice requires that all person be treated equally and fairly and be offered the best and safest procedures, regardless of cost.
However, resource limitations require the rationing of health care resources. A state must care for its citizens and keep the populations as â€œwellâ€ as possible. A state funded Medicaid program may have limited cash budgeted, requiring it to limit access to care, such as Arizonaâ€™s 2014 limitation of Arizona Health Care Cost Containment System (AHCCCS) coverage to parents with children, pregnant women, the disabled elderly (AHCCCS, 2021). In fact, AHCCCS must allocate its limited resources appropriately to provide adequate coverage to the greatest number of persons in the state, accomplished by closing coverage to young, relatively health segments of the population, limiting provider networks, and limiting drug formularies. Meanwhile, another patient on a robust commercial insurance plan may have access to a wider array of formulary drugs or the opportunity to see more care providers. Though not â€œfairâ€, it is the consequence of the need to ration a limited resource.
AHCCCS. (2021). Health Insurance For Adults beginning January 1, 2014). Retrieved from https://www.azahcccs.gov/Members/GetCovered/Categories/adults.html
CDC National Center for Health Statistics. (2021). Retrieved from https://www.cdc.gov/nchs/fastats/health-expenditures.htm
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Burlington, MA: Jones and Bartlett Learning. ISBN-13: 9781284144185
USA Facts. (2020). How do most Americans get their health insurance? Retrieved from https://usafacts.org/articles/how-most-americans-g…