HCFN
healthcare financing article.pdf

In a national healthcare plan it is unlikely that

Info icon This preview shows pages 17–19. Sign up to view the full content.

In a national healthcare plan, it is unlikely that clear and definitive rationing regulations regarding end of life and quality of life would emerge due to the political sensitivity of these issues. Even in Britain, political pressure has modified age-related rationing decisions (such as dialysis). Instead, rationing would probably be done through regional budgeting. A cultural bias against the elderly and their quality of life would place the elderly at significant risk for under-treatment. 67 The elderly at highest risk would be those who are minorities, have low social status, disability, and/or no family to advocate for them. The ethical model of “equality of opportunity” for national health care justifies its potential bias against the elderly by claiming that they have already had their opportunity in life. In paying for care, some believe a younger person should receive priority proportional to age (potential years of life). “Fairness between age groups in designing a health care system is appropriately modeled by the idea of prudent allocation over a life span … Under some conditions of scarcity, this implies that ‘pure’ rationing by age … is permissible.” 68 A term promoted in the 1994 Clinton plan was “generational solidarity”, which was mentioned often but only vaguely defined as “sharing benefits and burdens fairly across generations”. The general implication, though, seemed to be that the elderly should give up benefits for the sake of the younger. Another ethical issue of special concern for the elderly is euthanasia. When private funds are limited, will there be pressure to ask for or accept voluntary euthanasia? In a national healthcare plan, when acute care beds are needed for the acutely ill, but are occupied by the frail elderly, will involuntary euthanasia be quietly practiced? Involuntary euthanasia has been reported to some extent in most European countries that have nationalized health care, and it disproportionately affects the elderly. XII. Reproductive Medicine, Stem Cell Research, and Genetics Reproductive technology, stem cell research, and genetic manipulation raise many issues, but have similar ethical concerns in regards to financing. All these technologies are (or predictably will be) very expensive to
Image of page 17

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

© 2008 Leah M. Willson, MD, MA - 18 - develop and to utilize. Who will allocate funding and how will they decide? Who will regulate researchers and practitioners? Who will benefit and who will lose? Insurance companies in the past have generally refused to cover infertility as an illness or disease, so most people have had to pay out-of-pocket for infertility services. More recently, infertile couples (who are often older and well-educated) have pressured through the political system for insurance coverage. As a result, many states now mandate insurance coverage for infertility.
Image of page 18
Image of page 19
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern