third-party payers in the healthcare | Homework Help

Part 1

Healthcare providers are supposed to provide high quality to customers equally.  However, as costs of healthcare services increase, low income people cannot access high quality healthcare services. In addition, third-party payers are increasingly less willing to underwrite the cost of various procedures. Both physicians and managers alike face resource allocation decisions that were unheard of only a few years ago (White, 2014). When resources are limited (financial, technical and knowledge resources) equitable and appropriate distribution is necessary. Ethics as a disciplined study of moral decision-making provides tools that individuals, organizations and communities may use to determine and justify the norms and structure of the terms under which scarce resource allocation decisions are made.

There are some ethical issues that are associated with making decisions in the allocation of scarce resources, such as justice and equity, autonomy, and respecting the integrity of the human body (White, 2014). In terms of justice, justice is the primary ethical consideration in the area of healthcare resources allocation since justice is concerned with fairness or equity in distributing goods to people. For example, in any health plan, organization or society, there will be a wide range of demand for services ranging from individuals who require few healthcare services to those who require continuous care for life. No one would advocate the provision of services to healthy individuals just to get an equal share of publicly financed health care. One aspect of autonomy is that patients are equally to be provided with information enabling them to give informed consent or engage in informed decision-making with respect to their healthcare or treatment.

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Part 2

A very important ethical dilemma involved in the allocation of scarce healthcare resources, involves the dilemma of providing important care to individuals based upon need instead of ability to pay. This is an ethical dilemma due to the fact that it is clearly not just and right to deny individuals the care that they need based upon income considerations, which allows individuals of higher levels of income to be able to obtain care based upon their financial standing, instead of healthcare need-based criteria. “Decisions associated to scarce resource allocations are made in consideration of the ethical principles of autonomy, and justice. In the future, complex ethical issues relating to allocation of scarce resource are more likely to increase” (Maddox, 1998).  The rationing of scarce healthcare resources poses an even more formidable ethical dilemma, due to the fact that this rationing will usually involve giving first priority to individuals that are viewed as important in society, and this is usually determined by their socio economic status, which is definitely unethical.


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