Ethics of Public Health policies
Public health ethics refer to moral principles that guide the provision of healthcare. On the other hand, public health encompasses the health of members of a community in terms of availability of healthcare facilities, clean water, and healthy foods and nutrition, protection from communicable diseases, and access to mental healthcare (Spike, 2018). Public health officials are obligated to provide the public with, and information on healthcare. Some of the public institutions mandated to safeguard the public’s health include the federal, state, and local governments (Spike, 2018). These institutions are tasked with policy formulation and implementation to ensure that each individual has access to quality healthcare.
Public health principles are put in place to ensure access to quality healthcare and fairness in healthcare provision. These principles include autonomy, justice, beneficence, and non-maleficence (Coughlin, 2007). Autonomy in healthcare refers to the patient’s ability to make decisions regarding their health. For example, if a patient is of sound mind and has attained the legal age to make their own informed decisions about their health, it is the patient’s right to decide on whether to accept treatment or not. There are, however, cases whereby a patient may need help to make decisions. For instance, if a patient is unconscious, a next of kin will be required to decide for the patient. This rule also applies to the underage. Justice in healthcare involves ensuring that every individual can access healthcare without discrimination. Currently, there are still discrepancies in the healthcare system that lead to injustice and discrimination due to systemic racism and the healthcare sector (Clemans-Cope et al. 2012). Public health requires beneficence; this is the provision of services for the good of the patient regardless of the caregiver’s opinions of the patient. Healthcare workers should not show favoritism or discrimination of any kind. Lastly, non-malevolence practice in healthcare requires that healthcare workers do not take part in any actions that may harm the patient.
The Ethics of the Affordable Care Act
According to the Affordable Care Act, all American citizens, as well as legal residents, are required to have a health insurance plan. The affordable care plan, otherwise known as Obama Care, was introduced to try to reduce the healthcare gap between the rich and the poor by introducing a cheaper option to the private insurance policies. As a result, affordable healthcare has helped in regulating the healthcare sector, which was previously dominated by either private insurance or following the pay per visit model. The Affordable Care Act covers patients of all ages, race, gender, sexual orientation, medical history, as well as social-economic background (Spike, 2018). It has helped to bridge the ethical gaps in healthcare by providing an inclusive and cheaper program that has enabled millions of Americans to access health services such as psychiatric care. The program offers equitable access to healthcare.
The Affordable Care Act, however, fails in giving the public a choice in their healthcare matters. The act requires that all Americans enlist with a healthcare program failure to which they may face penalties. This directive goes against public health ethics that states that people should be allowed to make choices on how they want to pay for their healthcare (Cauchi, 2016)
According to Twersky-Kengmana (2015), the Affordable Care Act failed in forcing mental health patients to seek care from non-specialists in public health facilities. The need for professional care leads to a situation whereby patients do not have access to specialized care that is accessible through private practice. The affordable care act is also a value-based program that is measured depending on healthcare standards that are set by the federal government. Using federal standards may not be a reflection of the quality of patient care accorded to patients in this program. The federal standards for healthcare may fail to care for patient needs because of the disconnect between what the federal government intends to achieve and what the people on the ground need. The local government is, therefore, crucial in bridging this gap by interacting with the community.
Public health laws
Public health laws, on the other hand, have some ethical issues that need addressing. The individual mandate law, for instance, is unethical in the sense that it requires the public to pay the healthcare premiums without fail (Cauchi, 2016). Imposing a penalty on defaulters is a form of taxation that is unfair for the public. The people affected may be unable to pay premiums due to economic constraints; the individual mandate law is more harmful than useful to the public.
The Florida Medicaid eligibility law, on the other hand, provides access to medical care for the vulnerable in society, namely the aged, pregnant women, children, and people living with disabilities. This eligibility law, however, leaves out a section of the population. The law allows for people living below the federal poverty level to access medical care. There are, however, millions of Americans that do not qualify in these criteria but still are not able to afford healthcare. This law is, therefore, unethical since it fails to protect the entire population without discrimination.
Recommended Changes to the Affordable Healthcare Act and Public Health Laws for them to Adhere to Ethical Principles
They are changes that can be made to the healthcare act to make it more inclusive. First, an amendment of the healthcare act is necessary to aid in the inclusion of people from all socio-economic backgrounds in the healthcare program. The eligibility for Medicaid should not be only for those that are recognized by the federal government as people living below the poverty level. The healthcare program should also be liberal in allowing people to decide if they want to join the program.
References
Clemans-Cope L; Kenney GM; Buettgens M; Carroll C; Blavin F; (2012). The Affordable Care Act’s Coverage Expansions Will Reduce Differences in Uninsurance Rates by Race and Ethnicity. Retrieved June 1, 2020, from https://pubmed.ncbi.nlm.nih.gov/22566430/
Coughlin & S., S. (2007, November 6). Public Health Ethics: Theory, Policy, and Practice: Edited by Ronald Bayer, Lawrence O. Gostin, Bruce Jennings, and Bonnie Steinbock. Retrieved June 1, 2020, from https://academic.oup.com/aje/article/167/1/121/186053
Twersky-Kengmana, R. (2015, February 23). An Ethical Perspective on the Affordable Care Act. Retrieved from https://pro.psychcentral.com/an-ethical-perspective-on-the-affordable-care-act/
Cauchi, R. (2016, April). State Laws and actions challenging certain health reforms. In National Conference of State Legislatures. Washington (Vol. 12).
Spike, J. P. (2018, February 7). Principles for public health ethics. Retrieved from, https://www.sciencedirect.com/science/article/pii/S2352552517302141.