Third-party financiers dominate the current health financing system. These financiers include the government through programs such as Veteran Affairs or the Centers for Medicare & Medicaid Services (CMS) (Reinhardt, 2019). There are also the private sector financiers dominated by insurance companies and, in some cases, the employers. A majority of these arraignments include co-payment systems, where patients have to pay a segment of the medical bills out of pocket. Others cover only parts of care, such as hospital bills, but does not cover others such as medication and ambulatory care. Finally, most of the private sector financier is tied to employment and will be lost in the case the holder loses employment (Reinhardt, 2019).
The financial arraignment creates unavoidable ethical dilemmas for most caregivers in America. Clinicians always want to provide the best possible care for patients, including running the necessary diagnostic processes and offer appropriate therapeutic care (Reich, 2016). However, the system demands that unless a patient is in critical care, the level of service offers depends on the capacity to pay. The inability to serve patients due to financial reasons creates a dilemma as clinicians wonder whether to follow their oaths of service or administrative instructions (Reich, 2016).
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Secondly, the fact that health financing is tied to employment. Further, the current employment system increases the propensity for ailing employee to lose their jobs. Caregivers face challenges where they have to discontinue care because a patient has lost employment and, by extension, health insurance (Reich, 2016). Some of the more challenging experiences is getting to see the same patients come back under for treatment at government expense because they are not critical. An arrangement that declines early treatment to needy patients, only to provide it later when the patient is critical points to a faulty system. Not only does such an arrangement increase eventual costs but also visit unnecessary suffering to patients while reducing proclivity for positive outcomes. Further, such a system is depressing for caregivers (Reich, 2016).
References
Reich, A. D. (2016). Selling our souls: The commodification of hospital care in the United States . Princeton University Press.
Reinhardt, U. E. (2019). Priced Out: The Economic and Ethical Costs of American Health Care . Princeton University Press.
