Employer-Sponsored Health Insurance

Employer-Sponsored Health Insurance

Ethical Concerns Existing Due to the Employer-Sponsored Health Insurance

The dominant form of employer-sponsored health insurance in the United States raises several significant ethical concerns and problems, including access inequities, discrimination and pre-existing conditions, and limited autonomy and job lock.

Access Inequities

The unequal access to healthcare based on employment level is one of the biggest ethical issues. There is a coverage gap because this method excludes people who are self-employed, unemployed, or working part-time. Because those without employer-sponsored insurance may put off or forego critical medical care owing to financial constraints, this circumstance exacerbates inequities in health outcomes. The lack of universal coverage violates the ethical imperative of ensuring everyone has equal access to necessary healthcare treatments. Do you need help with your assignment ? Feel free to contact us. Our team is ready to help.

Discrimination and Pre-existing Conditions

Health insurance an employer provides can discriminate against persons with pre-existing conditions or those who work in positions without insurance benefits. Those who are judged higher by insurance providers may face increased premiums or even coverage denial (Hecker, 2023). This method violates the idea of justice and equal treatment by unfairly punishing people for circumstances out of their control. Healthcare choices should be based only on medical necessity, not on a person’s work situation or medical history.

Limited Autonomy and Job Lock

Due to the connection between health insurance and employment, some people may feel trapped in their current positions to keep their health insurance. This restricts their ability to pursue employment prospects or start a business, affecting their welfare and economic mobility. This kind of option limitation is inconsistent with the ethical ideal of individual autonomy and self-determination and is inappropriate in a healthcare system.

Reform Actions by the U.S. Government to Reduce Ethical Concerns

The U.S. government has taken several reform actions to address the ethical concerns and problems associated with the dominant form of employer-sponsored health insurance. While these reforms may not have eliminated the circumstances, they represent steps toward creating a more equitable and inclusive healthcare system. These include the Affordable Care Act, Medicaid expansion, and the promotion of value-based care.

The Affordable Care Act (ACA)

The Affordable Care Act (ACA), sometimes known as Obamacare, sought to increase access to healthcare and lessen prejudice based on pre-existing diseases (Sammut, 2023). It created Health Insurance Marketplaces so people could buy insurance independently and not just rely on employer-sponsored policies. Insurers cannot deny coverage based on pre-existing diseases, and subsidies were created as part of the ACA to make coverage more affordable for those with lower incomes.

Medicaid Expansion

The ACA allowed states to increase the number of low-income adults who qualify for Medicaid. This extension was chosen by many states, which raised the number of vulnerable groups previously not covered by employer-sponsored insurance. The coverage gap for those without access to commercial insurance through their employers was lessened due to Medicaid expansion.

Promotion of Value-Based Care

The U.S. government has been pushing for a shift from a fee-for-service healthcare model to one that emphasizes value-based care. By encouraging providers to focus on the quality of care rather than the quantity of services, this approach can potentially lead to better outcomes and cost savings, benefiting both individuals and the healthcare system as a whole. This shift aligns with the ethical principle of justice by aiming to improve healthcare equity and ensure that patients receive appropriate, effective treatments based on their needs. It also promotes responsible resource allocation to achieve sustainable and inclusive healthcare for all.

The Ethical Principle of Justice and Its Role in the U.S. Healthcare System

Fairness, objectivity, and equality in distributing burdens and rewards within a society are the ethical principles of justice (Morgan et al., 2023). This principle highlights the importance of ensuring everyone has the same opportunities, resources, and fundamental rights, regardless of socioeconomic standing, color, gender, or any other arbitrary disparities. The principle of justice is essential to the U.S. healthcare system because it ensures that services are provided equally, that no one is unjustly denied access to necessary medical care or subjected to discrimination in doing so, and that policies and reforms work to close gaps in health outcomes between various groups of people. Justice in healthcare requires addressing barriers to access, eliminating discrimination, and working towards universal coverage to create a more equitable and just system where everyone can achieve optimal health and well-being.

 References

Hecker, N. (2023). Insuring reproductive assistance: The need for a federal mandate requiring insurance companies to pay for fertility treatments. Family Court Review, 61(2), 413–427. https://doi.org/10.1111/fcre.12704

Morgan, J. D., Neufeld, S. D., Holroyd, H., Ruiz, J., Taylor, T. J., Nolan, S., & Glegg, S. (2023). Community-Engaged Research Ethics Training (CERET): Developing accessible and relevant research ethics training for community-based participatory research with people with lived and living experience using illicit drugs and harm reduction workers. Harm Reduction Journal, 20(1). https://doi.org/10.1186/s12954-023-00818-6

Sammut, J. (2023). The healthcare system and manufacturing in America: An economic analysis. https://savingtheworld.us/wp-content/themes/fixusahealthcare/images/blog/The%20Healthcare%20System%20and%20Manufacturing%20in%20America%20-%20An%20Economic%

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Description UNIT 4
Primary Discussion Response is due by Thursday (11:59:59pm Central), Peer Responses are due by Saturday (11:59:59pm Central).

Primary Task Response: Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions with your classmates. Be substantive and clear, and use examples to reinforce your ideas.

Employer-Sponsored Health Insurance

In most other countries in the world, the government plays a central role in covering health care needs; however, in the United States, the private sector (in the form of employer-sponsored health insurance) serves as the dominant form of medical coverage. For this assignment, discuss the following:

Describe and discuss some of the ethical concerns or problems that exist because of the dominant form of employer-sponsored health insurance.
Discuss reform actions that the U.S. government has taken to reduce the ethical concerns or problems that you discussed.
Define the ethical principle of justice, and discuss its role in the U.S. healthcare system.
Responses to Other Students: Respond to at least 2 of your fellow classmates with at least a 100–200-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

What did you learn from your classmate’s posting?
What additional questions do you have after reading the posting?
What clarification do you need regarding the posting?
What differences or similarities do you see between your posting and other classmates’ postings?
For assistance with your assignment, please use your textbook and all course resources.

Discussion Board Rubric