Personal Philosophy of Life Applied

¶ … Personal Philosophy of Life Applied to My Profession

The Intersection of Human Rights and Modern Healthcare

My philosophy of the equal rights of all persons applies directly to the current national controversy over national healthcare reform. Because this relates to my profession, it is a topic that interests me personally. My position on the various issues themselves is a function of my philosophical beliefs about what is fair and equitable in American society. Specifically, my philosophical perspective addresses the inequity of allowing unrestricted profit from healthcare services and health insurance and the entire fee-for-service model of medical reimbursement upon which American healthcare is dependent.

The Fundamental Ethical Problem with For-Profit Healthcare Services

Profiting from Pain and Disability

In principle, I believe that the entire concept of profiting from illness and disability contradicts what is ethical and morally right in modern human societies. Certainly, medical doctors deserve to be compensated for the amount of time, effort, and commitment involved in becoming qualified in their profession. On the other hand, there is a significant difference between what is fair compensation that genuinely reflects the social contribution of becoming a doctor, nurse, or other medical service provider and the completely unrestricted compensation that also allows some specialist medical doctors to earn many hundreds of times the salary of ordinary people like most of their patients. According to my philosophy of human rights in relation relative needs, essential services such as medical services should be subject to some sort of regulation that limits the maximum amount of profit earned from treating human illness and disease.

Health Insurance

Currently, the annual cost of healthcare in the United States is almost two and a half billion dollars annually (Reid, 2009). Two-thirds of that staggering amount represents the direct cost of all of the medical services provided to patients; the entire remainder, representing approximately $800 million, is the added cost associated with the for-profit healthcare insurance industry that actually adds nothing in the way of medical services (Kennedy, 2006; Reid, 2009). The amount of money at issue would probably go further toward improving American healthcare delivery to those in need of medical care that they cannot afford than most of the reforms currently being debated in Washington.

Just as in the case of the professionals who work so hard to earn medical degrees and fulfill grueling internships to become doctors, those who provide medical insurance also have a right to fair compensation. However, from a basic ethical and moral perspective that presumes that all citizens have an equal right to essential services, there is no justification for allowing unrestricted profits from insuring medical risks. There is nothing necessarily immoral about for-profit health insurance, provided there is appropriate regulation and a maximum limit to the amount of profit in relation to the value of the services provided.

In that respect, the primary moral and ethical problem with the current for-profit health insurance industry is that there is absolutely no way to justify costs amounting to thirty percent of the cost of medical services for providing purely administrative services. That is particularly true in light of the fact that even Medicare, a federal program that is severely under-funded and with a history of administrative problems manages to accomplish the same functions as private-sector health insurers for approximately one or two percent of the total cost of the medical services they administrate instead of one-third of those costs (Kennedy, 2006; Reid, 2009).

Political Lobbying

In general, the entire concept of special interest group lobbying in Washington on behalf of private industry is a fundamental moral and ethical problem with respect to the principles of democracy and equal justice for all. This mechanism allows private sector industries (and other well funded entities) to exert influence that causes elected officials to support (or oppose) laws and public policies in the interest of those entities instead of equally in the interest of the general public.

This practice has traditional been justified by characterizing the process as involving nothing more than pay for access to public officials in order to make policy presentations in person instead of relying on the same ability (at least in theory) that individual citizens have to contact their elected representatives through traditional correspondence. In fact, there are tremendous advantages to lobbying public officials in person and it is largely a fiction that lobbying is not a form of legalized bribery. To the extent that is true, the entire process of political lobbying is a form of political corruption that violates principles of equal representations and equal rights.

Currently, there are approximately five to six special interest group lobbyists working on behalf of the private health insurance industry for every single publicly elected representative in Washington, D.C. (Reid, 2009). The breakdown of political support for legislation and policies that benefit the industry reveals a remarkably close association between political contributions from that industry and the voting and statement records of political representatives (Kennedy, 2006; Tong, 2007). It is no surprise that the major source of opposition to some of the most potentially beneficial elements of healthcare reform at issue today comes from the representatives who have received the largest campaign contributions from the private health insurance industry and representatives from states where the largest corporate parents of private sector health insurance companies (Reid, 2009).

Preventative Medicine and Reimbursement Based on Beneficial Results

Sufficient information already exists from other nations that very strongly suggests that any efficient, affordable, and socially beneficial model of national healthcare must rely of a results-based fee structure instead of the fee-for-services model still relied upon in the U.S. (Kennedy, 2006; Reid, 2009; Tong, 2007). That is simply a realistic function of the fact that human beings tend to be motivated by whatever is most in their self-interest. Physicians are often dedicated to their professions but the format whereby their compensation is substantially determined by how many services they render and how many tests they perform provides an unavoidable ethical conflict that undermines the quality of healthcare services while inflating their costs tremendously.

In European nations (and in other countries), physicians earn bonuses for the actual measurable benefits their services provide to patients rather than for merely rendering services without any connection to their efficacy (Kennedy, 2006; Reid, 2009; Tong, 2007). Meanwhile, in the U.S., the cost of healthcare is increased by unnecessary testing because it is profitable and because there is virtually no general or holistic approach to patient welfare. For example, orthopedists in the U.S. may not address the fact that their patients smoke because those concerns are not within their specialty (Kennedy, 2006; Reid, 2009). In nations that have adopted the preventative medicine focus, all physicians address the overall health of their patients and there is no profit in providing medical services and tests that do not provide beneficial results (Beauchamp & Childress, 2009).

The Ethical Distribution of Healthcare Costs Based on Relative Affluence and Need

Perhaps the most significant ethical and moral issue in connection with equal rights to healthcare raised by the contemporary debate about American healthcare reform is in the area of the most appropriate source of funding for it. Unfortunately, the traditional format of reliance upon taxing the earnings of the young to finance the medical treatments needed by the elderly (and the poorest in the community) is no longer feasible because of demographic changes in the American population (Kennedy, 2006; Reid, 2009; Tong, 2007).