Abstract
The American public health sector has experienced several changes in the last few decades. The Simkins v. Cone Memorial Hospital case provided the most instrumental piece of legislation that brought significant changes in the access to health care in America. This paper shows that the 14th amendment was the most instrumental law in the case because it allowed amendments in the protection of equal rights in the American public and private health care sectors. The last section of this paper confers that the commercialization of the American health care law has greatly undermined the gains of the Simkins v. Cone Memorial Hospital case.
Court Level where Judicial Opinion Occurred
The legal opinion in the Simkins v. Cone Memorial Hospital case occurred at the federal court level because the Supreme Court (that made the decision) is a federal court (Lectric Law Library, 2013).
Opinion of Lower Court
A lower court had earlier ruled that the 14th amendment right did not apply to private hospitals, thereby allowing them to continue their discriminating practices, if they wished (Quadagno, 2005). However, the Simkins v. Cone Memorial Hospital case overturned this ruling after asserting that private hospitals did not constitute “private entities” if they sought federal funding (Reynolds, 1997).
Federal Laws in the Case
One instrumental federal law that played a big role in deciding the Simkins case was the 14th amendment right, which outlined citizenship rights and the equal protection of laws by the federal government. This law was significant to the Simkins case because it defined African-American rights to gain access to health care, as citizens of America (Quadagno, 2005).
How the Federal Law Defined the Case
On one hand, the application of the 14th amendment right to the Simkins case meant that African-Americans were citizens of America and would therefore be entitled to the privileges enjoyed by other American citizens (including the right to health care services). One the other hand, the failure to apply this law in the case would mean that African-Americans were not legal American citizens and therefore should not enjoy the benefits of citizenship, including the right to health care. The first argument prevailed.
Constitutional Amendments and Issues
Issues
The main issue in the Simkins case was the legality of practicing the “separate but equal” clause in private hospitals. Quadagno (2005) says that before the Simkins case attracted national attention, few hospitals admitted African-Americans as legitimate patients. This situation therefore formed the background of the Simkins case because it sought to eliminate the “separate but equal” clause, which brought this problem in the first place.
Amendments
Before the Simkins case, the Supreme Court had set a legal precedence, which outlined that the “equal protection” clause only applied to public institutions (Reynolds, 1997). This precedence informed most rulings of the justice system, for a great part of America’s history, until the Simkins v. Cone case in 1963 amended it.
Limitations of Reach
The Simkins case was limited in its reach because it sought to enforce the equal protection clause on a facility that was technically “private.” The equal protection clause only applied to public institutions and therefore if the Supreme Court applied a technical interpretation of the status of Cone hospital, it would have ruled that the hospital was not subject to the equal protection clause. In fact, this limitation led to the loss of the first case against Cone Hospital. Later, the Supreme Court reversed this decision.
Extension of Ruling
The application of the “equal protection” clause in the Simkins case marked the first time that the clause applied to private institutions. Its application spread across the nation (thereafter). Congress was at the forefront of championing the nationwide application of the ruling, after it passed the Civil Rights Act of 1964. Senator Harrison William is among the most notable public figures that championed the applicability of the law, on a national scale (mostly through health sector arguments). However, he was not however the only person who championed for this change. Quadagno (2005) says new staff in the Kennedy administration also pushed for these changes, including Lisle carter (deputy assistant secretary) and James Quigley (among others).
Is the Institute of Medicine (IOM) Waking Up?
Based on the assertions of Bowman (2013), it is difficult to support the opinion that the Simkins v. Cone memorial hospital case would make a huge difference in decreasing health care inequalities in America. This is because there are many other factors that currently play to counter its goal (increasing health care access). For example, the decreasing number of physicians in America is compromising access to primary care because the IOM has allowed nurses to substitute physicians (Bowman, 2013). Consequently, there has been a significant reduction in the quality of primary care. The high cost of health care in the US also undermines inequalities in the health care system because it gives a lot of access to economically empowered people (who can afford health care insurance), while segregating those who cannot. Thus while, the Simkins v. Cone case played an instrumental role in reducing inequality in health care access, current policies and provisions (mostly advanced by the IOM) work to the contrary.
The commercialization of health care services is among the biggest problems facing America’s health care system. This commercialization has tapped into the belief that public health care facilities do not offer quality care, while private health care facilities offer better health care services. The free-market principle, while useful to America’s economy, outlines the genesis of this problem. Due to the principles of “fair competition,” there has been a consistent advancement of the private sector in the provision of quality health care services, while the public sector has plays second fiddle in this regard. The application of fair market principles in the private sector has led to a low performance of the sector because it has contributed to the increase of health care and insurance costs, thereby limiting health care access to people who cannot afford such costs. In Canada, public health care facilities offer better health care services, compared private health care facilities (Bowman, 2013). Indeed, since profits do not motivate the government to offer health care services, health care in Canada is affordable. The opposite situation is true for America. If real progress should occur in the health care system, the commercialization of health care services needs to end.
The presence of multiple payers in the American health care sector also forms part of the health care problem because it contributes to the high health care costs in the country. When there are many payers in the system, health care costs are high (administrative costs, fraud or otherwise), thereby leading to high insurance costs. The presence of a single payer in the health care system (preferably the government) would solve this problem because it would eliminate market forces that contribute to the high insurance costs witnessed today. The presence of multiple payers in the system also traces to the existence of free-market principles in economic law. Again, part of the reason why Canada’s health care system is better than America’s system is the presence of a single payer. America should emulate this payment mode.
References
Bowman, R. (2013). Is the Institutes of Medicine Waking Up? Web.
Lectric Law Library. (2013). Introduction to the United States Legal System. Web.
Quadagno, J. (2005). One Nation, Uninsured : Why the U.S. Has No National Health Insurance: Why the U.S. Has No National Health Insurance. Oxford, UK: Oxford University Press.
Reynolds, P. (1997). Hospitals and Civil Rights, 1945-1963: the case of Simkins v Moses H. Cone Memorial Hospital. Ann Intern Med, 126(11), 898-906.