In most other countries in the world, government plays a central role in covering health care needs; however, in the United States, the private sector (in the form of employer-sponsored health insurance) serves as the dominant form of medical coverage. For this assignment, discuss the following:
Describe and discuss some of the ethical concerns or problems that exist because of the dominant form of employer-sponsored health insurance.
Discuss reform actions that the U.S. government has taken to reduce the ethical concerns or problems that you discussed.
Define the ethical principle of justice, and discuss its role in the U.S. health care system.
Full Answer Section
- Cost: The cost of ESI has been rising steadily in recent years. This has made it difficult for some employers to offer ESI to their employees, and it has also made it difficult for some people to afford the premiums for ESI.
Reform actions taken by the U.S. government to reduce ethical concerns or problems
The ACA has taken a number of steps to reduce the ethical concerns or problems with ESI, including:
- Prohibiting denial of coverage or charging higher premiums based on preexisting conditions: The ACA prohibits health insurance plans from denying coverage or charging higher premiums to people with preexisting conditions. This applies to both ESI plans and non-ESI plans.
- Establishing health insurance exchanges: The ACA established health insurance exchanges where people can shop for and purchase health insurance. This makes it easier for people to get health insurance, even if they do not have ESI.
- Expanding Medicaid: The ACA expanded Medicaid, a government-funded health insurance program for low-income people. This has helped to make health insurance more affordable for millions of people.
The ethical principle of justice and its role in the U.S. health care system
The ethical principle of justice refers to the fair distribution of benefits and burdens. In the context of health care, justice means that everyone should have access to quality health care, regardless of their income, employment status, or preexisting conditions.
The U.S. health care system does not fully embody the principle of justice. As I mentioned earlier, people who work for larger employers are more likely to have ESI than people who work for smaller employers. People who work in low-wage jobs are also less likely to have ESI. And people with preexisting conditions can be denied coverage or charged higher premiums by their employer.
There are a number of ways to improve the justice of the U.S. health care system. One way is to expand access to Medicaid. Another way is to create a single-payer health care system, in which the government would be the sole payer for health care. A single-payer system would ensure that everyone has access to quality health care, regardless of their income or employment status.
Ultimately, the goal of any health care system should be to provide everyone with access to quality, affordable health care. The U.S. health care system has a long way to go to achieve this goal, but there are a number of reforms that could be implemented to improve the justice of the system.
Sample Answer
Ethical concerns or problems with employer-sponsored health insurance
The dominant form of health insurance in the United States is employer-sponsored health insurance (ESI). This means that most Americans get their health insurance through their employer. There are a number of ethical concerns or problems with ESI, including:
- Job lock: Job lock is the situation where people are reluctant to leave their jobs because they would lose their health insurance. This can prevent people from taking new jobs that they might be interested in, or from starting their own businesses.
- Inequity: ESI is not evenly distributed throughout the population. People who work for larger employers are more likely to have ESI than people who work for smaller employers. People who work in low-wage jobs are also less likely to have ESI.
- Preexisting conditions: Preexisting conditions are health conditions that a person had before they got health insurance. Under the Affordable Care Act (ACA), most health insurance plans cannot deny coverage or charge higher premiums to people with preexisting conditions. However, ESI plans are not subject to the same rules, so people with preexisting conditions can be denied coverage or charged higher premiums by their employer.