Biomedical Ethics

Summarize Chapter 3 And 4
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Merits can be utilized as a basis for allocating funding health care. Health services might be offered only to individuals who take good care of themselves while individuals with harmful lifestyles should not be given publicly funded or private insurance or should be charged higher premium. Historically, health insurance firms either declined offering policies to people with preexisting conditions or charged high premiums or restricted benefits for such people. However, merit considerations were difficult to apply objectively. AMA criticized merit basis for allocating health care. AMA explains that it is impossible to determine which factors leading to diseased conditions. Only certain socially unacceptable behaviors like smoking can be justified for denying treatment.
In utilitarian perspective, care for a productive people of society should be funded, while care for unproductive people should have less priority. The social worth criterion based on deontological ground claims that not all individuals are treated equally; they should be judged on what they can contribute to the society. However, AMA criticized the social worth criterion since it can be utilized to deny providing treatment to the unemployed, the mentally handicapped, the elderly and other vulnerable groups.
AMA declares that physicians should support access to medical care all people and should not be restricted by considerations of personal attributes, economic or social status or the nature of health problems. Individuals should have all their health needs met irrespective of their ability to pay based on the system of comprehensive and universal coverage. However, this care coverage remains ideal goal, but has not been accomplished in any society.
Fee for services system refers to the distribution of health services based on the capability to pay. Health care providers are normally paid for their services, and patients enjoy wide varieties of medical care under this system. A safety net system for low income individuals can be utilized to offset the disadvantages of a pure fee for service system. The rich people could take advantages of greater choice, but low income individuals would only have access to basic care. The formation of Medicaid and Medicare programs in 1964 is a good example of a system of fee for service with a safety net. Medicaid and Medicare were intended to offer a safety net for the most vulnerable populations.
PPACA, formed in 2010, constitutes vital health care legislation since adoption of Medicaid and Medicare in 1960’s. Some major provision of the Act includes formation of state level insurance exchanges, subsides for small business to encourage them to provide health insurance for their employees, requirements that individuals purchase health insurance, subsidies for low income individuals to purchase health insurance, requirement for large businesses to provide health insurance for their employees, and extension of the Medicaid program provides coverage for individuals and families with low incomes.
In 2012, the United States Supreme Court upheld the constitutionality of several provisions of ACA. The Supreme Court main...