Reflective statement on professional practice and development

Nursing - Reflective Statement

MORAL OBLIGATIONS: DISPARATE WEALTH and HEALTHCARE the Issue of Disparate Wealth and Healthcare Availability:

The United States boasts one of the most advanced modern healthcare systems in the world, but many American citizens lack adequate access to appropriate healthcare. In part, this is the result of the predominance of modern healthcare management in the age of the third-party insurer payment system. The rise of third-party payment systems and managed healthcare and has dramatically increased the costs of medical care, which is a significant problem in and of itself.

Those problems are further compounded by the fact that approximately one-third of Americans have no health insurance. As a result, those who can least afford health insurance suffer disproportionately, because the prevalence of third-party payment makes necessary medical services even more unaffordable than before to those without health insurance. Direct mandatory payment by the wealthy for the healthcare needs of the less wealthy solves one moral dilemma, but substantially at the expense of another set of moral principles. The solution most likely involves reforming U.S. healthcare by addressing some of the underlying causes of exploding healthcare costs.

Toward a Solution:

It is difficult to argue that private individuals with greater financial resources owe a moral duty to pay for the medical (and non-medical) needs of the less fortunate, at least directly. On the other hand, one of the purposes of taxation by the State is to benefit the entire community, and in that regard, essential medical care and services are one of the most important aspects of government administration for the benefit of the community.

In principle, the State is morally justified in requiring proportionately higher tax rates of wealthier individuals and corporate entities for the purpose of making essential healthcare services more widely available to those less fortunate. Beyond taxation, requiring wealthier individuals to pay directly for health services of the less fortunate violates some of the most basic moral rights of personal sovereignty as well as various fundamental constitutional rights of due process and equal protection. However, there are other approaches to equalizing healthcare availability that do not require involuntary financial contribution of some citizens to finance the medical services of others.

One of the most important necessary healthcare reforms is the limitation of healthcare profits attributable to the third-party payment system. Specifically, the evolution of the modern healthcare system resulted in ridiculously inflated costs of diagnostic services and medical supplies by virtue of the fact that the largest portion of healthcare charges are absorbed by insurers. Therefore, hospitals and other service providers have continually increased their fees knowing that insurers rather than patients will be responsible for payment.