Issues That Affect Health Care Delivery

Health Care Reform

Since his presidential campaign, President Obama has placed a priority on health care reform. He has consistently restated his intention to increase the public's access to quality health care, reduce overall costs, and improve the quality and efficiency of healthcare delivery. The potential outcome would be public insurance options and new legal requirements for insurance companies. For example, companies would not be able to refuse or discontinue an individual's coverage based on preexisting conditions. The estimated cost for these health care reforms could be anywhere from $1 trillion to 1.2 trillion dollars over the next ten years. Clearly, many of these proposed changes can be viewed as positive, especially for Americans who do not have adequate health coverage or have lost coverage due to medical conditions. The major change resulting from this process is that public money, some from taxes, would be used underwrite the cost of care, and for the first time, an increased number of Americans would be receiving medical services through public providers as opposed to private insurance (Keating, 2009). A variety of ethical debates concerning government spending have resulting, the most recent of which is the debate of using public funds to provide women's health services, including abortions.

As recently as February, 2011, heated debates occurred in the House of Representatives (Sonmez, 2011) regarding the newly proposed "No Taxpayer Funding for Abortion Act." This Act would bar federal funding for abortions under the new national health care law, ensuring that taxpayer funds are not used to finance abortion and associated reproductive healthcare. This discussion is a clear example of how a new federal health care system would struggle to meet the needs of very divided political groups in the United States. When ethical issues, such as abortion or certain fertility treatments are considered as a part of national health plan, it's clear that constituents across the United States are in direct conflict with one another. An individual with anti-abortion views will most likely not want his tax money used to provide abortion procedures. He may also see abortion as an elective procedure that should not be paid for by federal health care services. Yet, restricting the use of these funds may make it impossible for pregnant women to use their own insurance benefits to access an abortion, and a woman carrying an unwanted pregnancy may not see the procedure as elective, but rather as a necessarily (Alonzo-Salvidar, 2011).

Federal health programs, such as Medicaid are already restricted from using federal funds to pay for abortion procedures, but this newly proposed bill would also restrict tax credits that may have been historically used to deduct medical expenses. In short, the bill would allow the Internal Revenue Service to reject deductions related to employee health care in the event that employee provided health care covers abortion (Alonzo-Salvidar, 2011). The issue could prove to be precedent setting because it would be the first time that law would prohibit people from using tax credit funds for a legal medical procedure.

The issue has created extensive debate because the right to choose abortion is protected by law. New laws related to the proposed health reform could eventually require women to pay out of pocket for expenses related abortion. This, in turn may have a particularly negative affect on vulnerable women, such as younger women with fewer economic resources, low-income individuals, or victims of domestic violence. In all of these cases, a woman may have a compelling reason to seek an abortion based on a lack of resources or concerns about raising a child in a violent household. In addition, victims of rape and women with serious medical concerns may not be able to access an abortion without paying out of pocket. Hospital officials at institutions with federal funding may also be prohibited from performing an abortion, even in cases where the mother's health is act risk (Alonzo-Salvidar, 2011)

Abortion opponents, however, maintain that federal funding of abortion procedures could essentially be viewed as federally sponsored abortion, and patients could use the low-cost procedures as a form of birth control, thus leading to an abuse the of system and misuse of federal healthcare coverage (Sonmez, 2011). Likewise, many politicians and their constitutions with socially conservative views are extremely resistant to the idea that tax money or federal tax deductions could in any way used to finance abortion, despite the fact that the right to choose is protected by law.