Introduction
Following the COVID-19 outbreak, various sectors of the U.S. economy were strained. Thus, the government had to activate relief money to cushion the affected parts of the economy, including healthcare. The coronavirus overwhelmed hospitals and compelled the U.S. government to allocate funds to address the disease’s problems to the U.S. economy, especially citizens’ health. The resource allocation to different hospitals faced numerous ethical challenges, necessitating a need to explore the problem from a resource allocation lens.
Global Health Issue
The novel COVID-19 is a critical health challenge that poses rampant problems to humankind. The illness is highly contagious and easily transmitted from one person to another. The first case of the illness in the United States was reported in February 2020, and within two months, the infections had spread throughout all the states. The disease spread to all countries, causing loss of lives and excessive damage to society. The lockdown interfered with normal economic functions, and all types of businesses were affected. All the industries were impacted by slowing down production and high unemployment rates. Financial struggles were experienced worldwide, with the most affected already struggling financially before the pandemic and those facing health inequalities (Belot et al., 2021). Due to the pandemic’s struggles, the U.S. enacted a policy called Coronavirus Aid, Relief, and Economic Security Act (CARES). The policy was developed to help provide economic relief from the pandemic’s burden.
U.S lawmakers agreed to pass the bill CARES Act in March 2020 to blunt the impact the COVID-19 pandemic had caused on the economy. This stimulus bill was worth $2 trillion, making it the largest rescue package in U.S. history. (Cortes & Forsythe, 2020). The CARES act had set goals to assist the state and the local government with financial relief. A portion of the CARE act was supposed to fund the state and the local hospitals and health departments. This health department was supposed to benefit from purchasing PPEs, health response and preparedness activities, testing the people for coronavirus, controlling the infections, and contact tracing of the suspected and infected individuals. Due to the lack of stipulations, many hospitals did not have the appropriate personal protective equipment (Mason et al., 2020). They lacked the financial resources to purchase other essential items, such as COVID testing kits.
Ethical Resource Allocation Framework
The ethical resource allocation framework used to analyze the CARES Act is based on three primary ideas. First, ethical resource allocation must provide equal value to each person or entity. Features such as sexuality, ethnicity, gender, and religious views should not impact resource allocation. In addition, discrimination based on ability or wealth should be avoided. Second, the ethical resource allocation framework focuses on gaining the most out of scarce resources. In terms of healthcare, maximizing the use of resources may indicate different things, including cost-effectiveness, priority to frontline workers and the young, efficient resource use, and priority to persons with care responsibilities (Dawson et al., 2020). Third, the framework prioritizes those in the most need, including cash-strapped hospitals and overwhelmed medical institutions.
Policy Justification for Resource Allocation
The policy determined how resources would be used based on the pandemic’s most affected areas. The resources were allocated to these places, and medical departments were issued with the necessary equipment to counter the infections (Emanuel et al., 2020). Areas with high populations of people were to receive more funding as these were the places most likely to record more infections. In addition, mitigating the risks of infection is more challenging in these areas. Hospital units with quarantine facilities were scheduled to receive more resources to care for the infected individuals and those suspected to have contact with infected people to lower the chances of infections to the medical personnel. The criteria used to justify resource allocation to hospitals differs from what the proposed ethical framework uses. The ethical framework prioritizes all kinds of hospitals irrespective of their size, pre-pandemic funding, and activities (Cantor et al., 2021). However, the CARES Act emphasized the need to allocate based on the size of pre-pandemic funding, resulting in uneven allocation.
Outcomes Resulting from Policy Allocations
The outcomes of the policy were that money was allocated to ensure quality healthcare during the pandemic. One billion dollars were allocated to produce PPEs and other health products (Fallucchi et al., 2021). However, Defense Department lawyers determined that the allocated money was not used adequately for pandemic-related purposes. Within a week, hundreds of million dollars of the funding was used for other military use (Cortes & Forsythe, 2020). To a large extent, the CARES Act effectively met its goals of assisting individuals and families facing struggles due to the pandemic by providing support for hospitals and healthcare professionals and appropriate personal protective equipment. Before the pandemic, there were shortages of PPEs, especially the N95 mask, which was most needed during the pandemic as they were efficient (Young et al., 2020). The bill was supposed to help curb this challenge and help the health care professionals stay safer during the pandemic.
If the policy had used the proposed ethical framework to allocate funds to various hospitals, there would be no disparities in funding across U.S. states. The framework advocates for equality in terms of the funds allocated. Small and cash-strapped hospitals received fewer funds, making their response to the coronavirus pandemic inadequate due to a lack of resources (Dawson et al., 2020). Using the proposed ethical framework, states could have allocated money based on multiple data points instead of considering hospitals’ size and pre-pandemic funding.
Tradeoffs
The tradeoff occurred when some healthcare organizations received more resources compared to others. For example, large hospitals, in terms of Medicaid revenue, received more money than rural area institutions. In addition, hospitals with increased endowment funds were allocated more CARES Act payments. Ultimately, tradeoffs were made based on the size of a hospital, with smaller ones receiving less aid. If the proposed ethical framework were used, the tradeoff would have been between other sectors and the healthcare industry. Various sectors received aid, including education and relief stipend checks (Dawson et al., 2020). Thus, the ethical framework would reduce money allocated to education and relief stipends to accommodate increased healthcare funds.
Fairness of Policy
The policy was not fair based on the preferential treatment of various groups of healthcare institutions. Hospitals with more pre-pandemic money had a high chance of receiving more CARES Act funding. In addition, hospitals that had increased their assets by ten percent pre-pandemic received 5.3 percent more in the allocated money (Cantor et al., 2021). Nonprofit and teaching hospitals were also preferred compared to critical access hospitals, leading to significant funding disparity that reduced care quality in rural and critical access hospitals.
Conclusion
With the advent of the COVID-19 pandemic, health care and economic expenditures surged worldwide. The virus could not have foreseen the devastation of the entire world. In the pandemic’s early stages, frontline healthcare workers could not correctly treat patients because they lacked adequate supplies and training. The CARES Act was created to assist those affected financially by the pandemic; however, it was inadequate and did not maximize the use of available monies.
References
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