Payment system reforms in healthcare
Payment system reforms in healthcare have allowed for the rise of for-profit healthcare facilities. In the past, healthcare was mostly on a non-profit basis. Throughout medical history, healthcare has been charitable, but that has drastically changed in the recent past as the number of for-profit hospital and facilities have skyrocketed. The commercialization of healthcare is very attractive, and for-profit healthcare facilities gain immense revenue. The paper evaluates the ethical viability of this system and whether the profits gained by healthcare organizations support sustainability.
The ethical concerns related to payment system reforms are in the fact that most for-profit hospitals are so concerned about the money that they forget their responsibility to the community. For-profit hospitals establish extremely high healthcare charges that allow them to gain massive revenues. Their payment systems stand to be discriminatory since they have no consideration for low-income patients. The poor and disadvantaged patients are, therefore, denied access’s to the best healthcare by the high charges (Andre & Velasquez, 2020). The goal of healthcare is to improve health and access to care, and yet for-profit hospitals seem to be doing the exact opposite. While paying for care is validated since healthcare professionals have to earn their income, the commercialization of healthcare has led to unregulated charges that are only defined by individual organizations. These conditions have, therefore, led to the ethical concern on whether for-profit businesses care about their patients or are just out there to exploit patients with money.
The payment systems in for-profit healthcare impact greatly on the physician-patient relationship. For-profit payment systems, for example, are quite high and can cause mistrust between patients and physicians (AMA, 2020). For-profit hospitals are known to admit patients following certain criteria that show they can afford the established cost of care. Examples of such criteria include verification of insurance cover from the patient. When healthcare facilities turn down patients because they do not have insurance, for example, these patients lose their trust in physicians and start questioning whether physicians really have their best interests at heart. In other cases, physicians have been known to subject patients to unnecessary medical procedures as a way to increase the costs of healthcare. Healthcare providers should respect patient autonomy by being truthful. They must be honest about the required healthcare processes and inform the patient of all possible treatment plans (AMA, 2020). These patients, thereafter, have to choose which processes they would prefer. Physicians that put patients through unnecessary processes for financial gain impact negatively on the physician-patient relationship.
Currently, most healthcare organizations are for-profit. The non-profits are very few and are the only hospitals that care about disadvantaged populations. The for-profit hospitals are not financially responsible since they earn a lot of revenue, but they do not use the money for the benefit of the community. They could, for example, set aside programs that help avail care for the poor despite being for-profit businesses. The non-profit hospitals have been able to afford the poor care by overcharging paying patient (Andre & Velasquez, 2020). The extra money is then used to pay for the treatment of the poor. For-profit hospitals make way higher revenues than non-profit hospitals but do not use it for the benefit of the less fortunate. Furthermore, they benefit greatly from government-subsidized programs such as Medicaid and Medicare and even from free medical research and education. Even so, they feel no obligation to contribute their fair share to the community, especially to the poor patients who need help the most.
American Medical Association (AMA). (2020). Code of medical ethics: Financing and delivery of health care. Retrieved from https://www.ama-assn.org/delivering-care/ethics/code-medical-ethics-financing-and-delivery-health-care
Andre, C., & Velasquez, M. (2020). A health bottom line: Profits or people? Retrieved from https://www.scu.edu/ethics/focus-areas/bioethics/resources/a-healthy-bottom-line-profits-or-people/