Introduction
The article “Racial/Ethnic Disparities in Health and Life Insurance Denial Due to Cancer among Cancer Survivors” investigates cases in which patients with cancer are denied insurance coverage. In particular, the issue centers on racial and ethnic disparities and the rates of insurance denial. The Affordable Healthcare Act (ACA), more commonly known as Obamacare, was passed in 2010, and its goal consisted of making healthcare more affordable and accessible to a broader population (Zhao et al., 2020).
The ACA is meant to make insurance more accessible, and the healthcare law requires insurance plans to provide coverage to people with already existing conditions (Yabroff et al., 2020). However, even after the ACA was adopted, it still happens that companies deny cancer patients insurance coverage, and, as research has demonstrated, there is a noticeable bias toward refusing insurance for Black and Hispanic people. There are two major ethical problems concerning this issue: First, the decision to deny insurance to cancer survivors, irrespective of their ethnic identity, affects their physical and mental health. Second, the patients who are denied insurance based on both their diagnosis and their race or ethnicity are affected to a greater degree.
Denying insurance to cancer patients can have dire consequences for their health and well-being. Without access to proper medical care, many cancer patients may not receive the treatments they need or may delay seeking treatment altogether. This lack of care can lead to more advanced stages of the disease and ultimately reduce their chances of survival. Denying insurance based on one’s race or ethnicity adds another layer of discrimination to this issue.
The article by Lent et al. (2022), “Racial/Ethnic Disparities in Health and Life Insurance Denial Due to Cancer among Cancer Survivors,” reports on the high prevalence of this problem in the United States after the introduction of the ACA. Black and Hispanic people belong to vulnerable populations, and denying them financial support for cancer treatment is unethical. This paper will discuss the article’s findings by Lent et al. and what role nurses could play in supporting patients. It will also discuss the consequences of reversing similar decisions, the lessons for future situations, and how these situations affect nursing practice.
The Nurse’s Role
When addressing ethnic or racial discrimination in healthcare, nurses can play several roles. To begin with, healthcare providers need to understand the unique needs and challenges faced by minority communities. Thus, nurses need to be highly educated on the racial and ethnic discrimination that exists in the healthcare system.
Nurses should be taught about the historical context of racism in healthcare and its impact on marginalized communities (Weitzel et al., 2020). They should also learn about implicit biases and how they affect patient interactions. Such biases pose a risk to patient health – Lent et al. (2022) demonstrate that racial disparity in the rates of insurance denial is connected to health providers’ misconceptions about people of color. Therefore, nurses’ role is to advocate for patients and their wishes.
Nurses need to understand that certain ethnic groups are particularly affected by specific issues, such as cancer treatment and insurance problems. In the selected case, Black and Hispanic people with cancer are vulnerable not only because of their condition but also because of a higher risk of low income and other financial issues (Lent et al., 2022). Therefore, nursing education must include training on racial discrimination to ensure that future nurses are equipped with the knowledge and skills necessary for providing culturally competent care. It is also imperative for nurses to be educated on cancer diagnosis statistics and understand that racial minorities die from cancer disproportionately.
In the case of the selected scenario, the patient wishes to receive insurance covering their treatment and increasing their access to cancer medication. Therefore, the nurses can support those wishes by advocating for better insurance coverage and educating other staff members about achieving this goal. For example, racial minorities are often not provided with appropriate preventative screenings.
Nurses play a crucial role in preventive screening, identifying potential health problems before they become severe or incurable. This involves educating patients about the importance of regular check-ups and screenings and performing tests and assessments to detect early signs of disease. This way, nurses can play a role in bringing patients’ awareness of the importance of check-ups and influencing doctors to pay closer attention to these patients.
Increasing patient access to screening services does not pose any risks to nurses. Moreover, advocating for insurance does not affect nurses, as it concerns the relationship between the insurance company and the patient. Nevertheless, insurance organizations may view nurses negatively if the latter want to decrease their expenses and cut coverage for patients with cancer.
In this case, the nurse’s role is to pursue the ethical obligation of patient-centered care and decrease the existing disparity (Lent et al., 2022). Benevolence and justice are crucial to the nurse’s duties and the goal of attending to the patient’s wishes. Nurses can advocate for their patients by providing education on available resources and services, assisting with enrollment in health insurance programs, and connecting patients with community resources.
Social and Economic Consequences
Providing equal access to healthcare insurance to all cancer patients irrespective of any factors, including ethnicity and race, can have both economic and social consequences. On the one hand, there are negative economic consequences, primarily for insurance companies. The initial reason for not providing access to insurance to Black and Hispanic cancer patients is that insurance companies are reluctant to provide insurance to economically disadvantaged populations.
Black and Hispanic people are often believed to belong to this group as well. Thus, insurance companies are unwilling to give up a part of the profit they think they will lose if they provide insurance to everyone (Lent et al., 2022). Although some profit loss might be included, this cannot be an excuse for this type of law breach.
On the other hand, there could also be negative economic consequences for regular people. Due to being obligated to provide insurance to everyone, insurance companies may raise premiums for all policyholders to cover the cost of providing insurance to cancer patients. This could make healthcare less affordable for those who do not have cancer or other serious illnesses.
The social consequences, on the other hand, will bring positive changes to society in general and the lives of individual patients. To begin with, patients will be sure that they will be provided insurance regardless of their descent. Thus, every cancer patient will have an equal chance for health improvement and survival. Moreover, patients would be able to receive treatment without worrying about the financial burden, reducing stress and anxiety. Another positive consequence for society is patients’ increased productivity.
Black and Hispanic people represent an essential part of the working force. Therefore, cancer patients who receive timely and effective treatment are more likely to recover and return to work sooner. This would increase productivity and contribute to overall economic growth. Finally, this decision would help fight systemic discrimination and oppression. Addressing the manifestations of discrimination in today’s society is vital, as each instance hinders social advancement. Hence, society will benefit immensely and progress significantly by eliminating the disparities in the healthcare system.
Lessons
For similar situations in the future, it is essential to work preventively to avoid negative consequences. First, healthcare organizations must improve screening rates for Black and Hispanic patients and create conditions for more effective pre-cancer detection. Here, nurses may advocate for patients and their access to proper check-ups.
Second, an education rooted in ethical practices is essential for eliminating health disparities (ANA, 2015). The nurses’ task can be to implement change projects that use existing data, such as the examined article, to educate nurses and other healthcare providers about vulnerable populations. The study by Lent et al. (2022) demonstrates that the lack of education about disparities significantly contributes to low screening rates and missed diagnoses. Therefore, education and awareness are among the main lessons that should be learned to prevent the same issue from happening.
Effects on the Nursing Practice
The issue of insurance denial is complex for nurses to address when they do not possess the power to institute change within the organization. When insurance companies deny coverage for cancer treatment, nurses often must deliver the bad news to patients. This can be emotionally draining for nurses, who may feel powerless to help their patients.
In addition to the emotional toll, insurance denials can increase nurses’ workload. Patients denied coverage may need additional care or treatment options that require more time and resources from nursing staff (ANA, 2015). This can lead to burnout and job dissatisfaction among nurses. Furthermore, patients who cannot receive necessary treatments or procedures due to insurance denials may experience worsened health conditions or prolonged recovery times.
As noted above, the nurse’s roles in resolving the discussed issue are to advocate for the patient group, research the problem, and implement change. Thus, future practice improvements should focus on giving nurses power and resources to fulfill their roles and provide better care to patients. Social disparities such as the one presented in the article place patients in a vulnerable position and limit their access to care. This issue goes against the nurses’ strive for patient-centered, ethical, and high-quality care (ANA, 2015). Resolving racial and ethnic disparities must be one of the priorities for nurses’ future practice.
Conclusion
To conclude, denying insurance to cancer patients based on any reason is unethical, but doing so based on one’s racial and ethnic identity is highly discriminatory. The article considered as an example of this issue reveals a high prevalence of racial disparity among cancer patients. The authors show that insurance denial is a common problem that limits Hispanic and Black people’s access to care. It affects patients who already belong to vulnerable populations mentally and physically, and it impacts nurses and other healthcare personnel as well.
Nurses can play an essential role in changing this tendency by getting educated on the issue and becoming advocates. If the situation is reversed, there might be some negative economic consequences, but positive societal changes greatly outweigh them. Nurses should consider the information from the article and implement change in their workplace to avoid future problems.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Web.
Lent, A. B., Garrido, C. O., Baird, E. H., Viela, R. & Harris, B. (2022). Racial/ethnic disparities in health and life insurance denial due to cancer among cancer survivors. International Journal of Environmental Research and Public Health, 19(4), Web.
Weitzel, J., Luebke, J., Wesp, L., Graf, M. D. C., Ruiz, A., Dressel, A., Mkandawire-Valhmu, L. (2020). The role of nurses as allies against racism and discrimination: An analysis of key resistance movements of our time. Advances in Nursing Science, 43(2), 102-113, Web.
Yabroff, K. R., Reeder-Hayes, K., Zhao, J., Halpern, M. T., Lopez, A. M., Bernal-Mizrachi, L., Collier, A., Neuner, J., Phillips, J., Blackstock, W., & Patel, M. (2020). Health insurance coverage disruptions and cancer care and outcomes: Systematic review of published research. JNCI: Journal of the National Cancer Institute, 112(7), 671-687. Web.
Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: A review at 10 years. CA: a Cancer Journal for Clinicians, 70(3), 165-181. Web.