Global health portfolio overview and strategies

Health Care Reform Reflection

The 21st century has seen a great deal of effort and debate regarding the future of American health care as healthcare reform has been one of the most discussed and divided political issues in the most recent election cycle. The effort to pass comprehensive legislation to ensure a standard degree of coverage for all Americans has been in the works for over two decades. The passing of the health care reform assembled by the Obama administration has reignited the debate over the role and relationship between the state, the health care system, and the public. This is an opportune moment for healthcare industry workers to reflect upon these relationships and to interrogate their underlying philosophies and perspectives on the role of the health care industry at large.

Looking at health care from legal, ethical, and economic perspectives provides keen insight into the role of the individual within the larger system. With the passage of the health care reform act last year, the concept of the health system as a safety net has been given more national attention and speaks to contemporary attitudes about the responsibilities of medical professionals and public health systems. Through a legal lens, it has become clear that the responsibilities of medical professionals to the patients for which they provide medical care pertain largely to the elimination of liability and risk of malpractice. With health care reform, it remains to be seen how the legal framework in which health care workers operates will change and how economic considerations will impact the legal obligations and concerns of the medical workforce.

The matter of ethics in health care provision of services is similarly influenced by the philosophy by which one understands the role and responsibilities of healthcare to inform the operation and construction of a health care system. What is the fundamental purpose of the healthcare industry? How do we define healing and health in the contemporary public-private American medical system? These are questions that are important to address on an individual basis in addition to accepted standards of bioethics in order to develop an informed personal and professional standard of care.

A key issue surrounding the legal and ethical aspects of medical care is what the health care worker feels is necessary to provide to patients and their families. When personal issues are impacting the patient health and well-being, such as when a person who is dealing with homelessness presents with a chronic medical condition, there are a variety of ways in which a medical professional such as a nurse might respond to assisting the patient. While many social problems require a mandated reporting of the issue to social service divisions, the medical professional has the opportunity to provide more comprehensive care through arranging referrals, coordinating follow up care, and working as an advocate for his or her patient in order to attenuate the social issues and thus improve the health outcome. This is indicative of a broader conception of healing and health care, but one that still puts the health outcome and the needs of the patient at the forefront. It is the difference between a philosophy of care that aims for a minimal provision of care vs. A more expansive understanding of the medical professional's ability and obligation to cause no harm while treating and preventing illness.

The legal and ethical frames of health care also call to mind the relationships between medical professionals and professional association. One relationship that seems important to strengthen is that between clinicians and public health / social service professionals for the aforementioned purpose of being able to provide a more expansive definition of care to patients in an era that indicates a move toward reimagining the health care system as a broader safety net. Forging relationships between overlapping but separated industries will better prepare all parties for the treatment of patients and facilitate an exchange of resources and knowledge which would assist in the prevention of vulnerable persons from falling through the safety net. Universal health care is about more than providing a minimum standard of care to all persons; it demonstrates a prioritization of state resources being dedicated to the health and well-being of citizens.

Aside from the medical perspective, that entails an obligation to provide care, this makes sense from a purely macroeconomic level as well. A health population will be more economically robust than one that must cope with many large scale medical problems. Even a solid understanding and emphasis of bioethics and human rights-based medicine does not preclude the importance of understanding the financial impact of health care reform, and thus it is wise to be able to argue for the long-term financial benefits of such a system. While the political debate continues on comparing and contrasting limited government vs. expanded government rights and responsibilities, the financial bottom line is often the one thing that can surpass the political rhetoric.