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The issue of uninsured people in the United States is in strong logical relation to many legal and ethical implications. Some of these are quite clear and humanitarian and some are linked with other healthcare issues. Whatever the nature, the new reforms and steps being taken should correctly address these issues.
The ethical issues regarding the uninsured are a grave aspect of this subject. As health insurance is a kind of confirmation and security of being a US citizen and being looked after, being uninsured comes with a lot of ethical implications. The healthcare organizations seem to be in a position where they can exploit and use these uninsured ‘subjects’ for various purposes. It is a confusing situation for most patients when they see that they are welcomed as research subjects and are willingly admitted but are not treated the same way when there is a need to be treated medically or admitted. Research surveys from as early as 1996 show that the patients enrolled for research on arrhythmia, were seven times more likely to not have insurance than the uninsured people who did not participate. Not even that, but people who often go under experimental medication for money, receive less than those who have medical insurance. These include other long-term benefits as well, that the insured participants receive more than those who are uninsured. (The ethical dilemma of the uninsured) Healthcare providers also face ethical dilemmas when it comes to treating uninsured patients. Many have to choose between providing further medical treatment to patients when needed, knowing that the patient is not insured and would not be able to cover the treatment expenses. Many healthcare personnel ‘do the right thing but many argue that the ‘right thing’ is relative (Hall).
An ethical issue is also a trade-off that most drug companies face, that is to choose between providing higher discounts against earning higher profits. Presently, the companies have little or no interest in increasing discounts to promote medical insurance enrollments. The new US administration is looking into this issue and hopefully, congress and the companies will reach common grounds beneficial to the uninsured cause (Romano).
The greatest legal implications revolve around the issue of eligibility. Under this, the eligibility of immigrants and minorities is a big issue. In the late 1990s when immigration laws were reformed and relocation took place, the policies and moves resulted in n immigrant backlash. Health insurance activities also were affected as Medicaid reformed its policies and practices following the new direction in which the issue was going. Certain amendments were made including The Personal Responsibility and Work Opportunity Reconciliation Act. These amendments put a cap on the access to federal public benefit programs which included healthcare benefits. Also, it restricted coverage to people who have not lived in the US for at least five years plus any undocumented children and people. (Hannigan) These reforms increased the uninsured population and started the cultural and communication gap that is now being tried to be bridged.
Other implications include the issue of people who had insurance in the past but are no longer able to afford the expenses. There have been reforms and regulations about such scenarios as well but with the current economic situation, these policies need to be amended again. This will ensure that the current globalized scenario and financial situations are catered to, properly (Rosenbaum).
- Hall MA, and Schneider CE.. “Learning from the legal history of billing for medical fees.” Journal Of General Internal Medicine 23.8 (2008): 1257-1260. MEDLINE. EBSCO. [Library name], [City], [State abbreviation].
- Hannigan, Norma Stephens. “Blowing the Whistle on healthcare fraud: Should I?” Journal of the American Academy of Nurse Practitioners (2009): 18(11), 512-7.
- Romano, Michael. “If you have to ask, you can’t afford it.” Modern Healthcare 32.12 (2002): 17. MasterFILE Premier. EBSCO. [Library name], [City], [State abbreviation].
- Rosenbaum, Sara. “Medicaid and Documentation of Legal Status: Implications for Public Health Practice and Policy.” 2007. PubMed Central. Web.
- “The ethical dilemma of the uninsured.” 2009.