Ethics and Morality: Navigating Health Insurance Decisions

Value Conflict: Health Insurance and Business Ethics

Recently, businesses cutting costs on health insurance plans have raised serious concerns for employees. Companies want to shrink their medical bills arising from insurance plans, especially for employees with chronic conditions — and they believe they have found a solution (Abelson, 2015). That solution benefits the firms but not the workers. Companies heavily rely on high deductible premiums drawn from employees' salaries, imposing an extra financial burden on employees' families, who must pay large amounts for medical care, particularly for serious treatments. Consequently, employees feel discouraged from seeking treatment and are disappointed that their employers have created a conflict between business values and ethics.

Keeping employees healthy so that the business keeps running is a primary objective for employers. Some must make difficult decisions about deductibles, careful not to drive away their best people. Because there is a conflict between cutting costs on health insurance and covering my own cancer treatment expenses, I must make a strategic decision on the entire cost-cutting proposal. To keep the business running during the difficult period of a pandemic — when everyone needs medical attention, not just those with serious illnesses — I must rely on ethical decision-making (EDM), principally Rest's four-component psychological model, which encompasses moral awareness, moral judgment, and the intent of creating maximum benefit for all (Crossan, Mazutis & Seijts, 2013).

I plan to revise the health insurance plan based on value-based design (Miller, 2019). This method requires matching evidence-based practices to their practical application by consulting health professionals. Doing so would reduce readmissions and shorten illness treatment periods, naturally lowering health insurance costs. This process includes bundled payments, which represent another feasible cost-cutting measure for the business.

Personalized health insurance plans could help identify each employee's needs more precisely, since health concerns would be addressed individually. Employees would recognize that their employer acknowledges their individual needs, fostering a stronger connection to a firm that genuinely cares for them. Knowing employees and their needs personally builds a natural sense of trust, enabling more personalized healthcare decisions. It would avoid placing additional burdens on those who are genuinely in need while not extending unwarranted benefits to those who are already privileged.

Although this may raise other business ethics concerns, one additional feasible option for reducing health coverage costs is scrutinizing employees' medical data. This would provide an in-depth understanding of which employees are in the greatest need of coverage — such as those like me requiring cancer treatment — whose substantial medical expenses should be covered and to what extent. Analyzing the benefits of employees' improved health would in turn benefit the company. The company must be extremely vigilant in extracting and studying such data, and must first inform employees of the purpose before doing so.

Further in the ethical debate over healthcare coverage, the significant consequences of management's decisions would greatly impact the entire workforce and their families. I also contemplate introducing a proposal to move away from 100% free insurance plans by giving employees meaningful healthcare benefit options and choices. This would help them make informed decisions and better understand their authentic needs.

Personal Analysis: Values and Decision-Making Style

From my life experiences, I have faced security and abandonment issues since I was adopted at the age of four. I have always sought security and protection, and I feel I should offer the same to my team. I feel deeply empathetic toward my employees because I do not want them to feel as vulnerable as I did as a four-year-old.

My purpose and motivation are to keep the business alive and open to future growth. I sincerely hope that once the business regains momentum and gets back on its feet, we will provide full medical coverage to our employees. I believe every employee will understand the difficult circumstances we currently face for the company's greater good. All those connected to this company should recognize that these measures are for their brighter future. As soon as the company stabilizes financially, it will be in a better position to serve its workers. I cannot seek personal gain from this situation, since I am also paying for my own health insurance.

I want to feel at peace with the decision I make so that I can be certain it will produce the best possible outcome for everyone involved. I have not encountered a situation like this before, so there are no prior experiences or ideal solutions to draw upon directly.

I am an introverted extrovert who chooses to communicate — both orally and in writing — with care. I also embrace risk-taking. As noted, personal factors such as my fear of abandonment and security concerns have shaped my attitude toward risk. The conflict condition in which I feel most comfortable, confident, and effective is when both sides of a situation have been thoroughly explored. A deep investigation gives me the self-assurance that I understand the issue and can handle it better. In this way, the solution can be favorable to both parties — which is precisely what good ethical decision-making aims for: maximizing benefits on all sides.

Conclusion: Virtuous Leadership and Ethical Decision-Making

After analyzing this scenario, I recognize that translating personal values into company virtues and employee benefits sometimes requires making the most difficult of decisions. Such decisions must not only align with current laws and codes of conduct, but must also account for the country's regulations as they apply to employees from culturally diverse backgrounds. Diversity and inclusion must be an essential part of value-based leadership and the resulting decision-making process. Cultural competence enables a company to deliver the best possible products and services to customers, regardless of the organization's size. The foundational days of any business lay the groundwork for virtuousness and a powerful organizational culture that will serve the company's expanding workforce for years to come.

References

Abelson, R. (2015, September 22). Health insurance deductibles outpacing wage increases, study finds. The New York Times. https://www.nytimes.com/2015/09/23/business/health-insurance-deductibles-outpacing-wage-increases-study-finds.html

Bachman, C., Habisch, A. & Dierksmeier, C. (2018). Practical wisdom: Management's no longer forgotten virtue. Journal of Business Ethics, 153, 147–165. https://doi.org/10.1007/s10551-016-3417-y

Crossan, M., Mazutis, D. & Seijts, G. (2013). In search of virtue: The role of virtues, values and character strengths in ethical decision making. Journal of Business Ethics, 113, 567–581. https://doi.org/10.1007/s10551-013-1680-8

GBH Forum Network. (2014, April 1). Giving voices to values: How to speak your mind when you know what's right [Video]. YouTube. https://www.youtube.com/watch?v=A-vOpCWGU8o

Harvard University. (2013, May 23). Building trust: Giving voice to values — Mary Gentile, IECO-RCC [Video]. YouTube. https://www.youtube.com/watch?v=UQ3WZ9nv7vQ

Kaptein, M. (2019). The moral entrepreneur: A new component of ethical leadership. Journal of Business Ethics, 156, 1135–1150. https://doi.org/10.1007/s10551-017-3641-0

Meyer, M. (2018). The evaluation and challenges of the concept of organizational virtuousness in positive organizational scholarship. Journal of Business Ethics, 153, 245–264. https://doi.org/10.1007/s10551-016-3388-z

Miller, S. (2019, February 27). 15 ways employers can reduce health care spending that aren't cost-sharing. SHRM. https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/top-ways-employers-hold-down-healthcare-spending.aspx

National Conference of State Legislatures. (2018, December 9). Small and large business health insurance: State and federal roles.