The Approaches to Managing Health Systems - Coursework Example

Managing health systems

There exist various regulations and policies set by healthcare institution to ensure that the actions of the healthcare providers are ethical. The choice of the regulation is hugely influenced by whether the regulation under debate follows the utilitarian or the deontological approach. The paper will discuss regulations that are based on the utilitarian and deontological approach to help in outlining the importance of ethics in the healthcare institutions.

The ethics stipulated by a specific approach that is adopted by a healthcare institution determines the duties and obligation of the nurses. Two main approaches in the medical ethics that influences decision-making include the deontological and the utilitarian approaches (Mandal et al. 2016). Under the utilitarian approach, the outcomes and consequences can justify the means that have been adopted to achieve those results. On the other hand, under the deontological approach, the means used in achieving a given result is equally important to the achieved results and outcomes. Most of the emphasis under the deontological approach is placed on the greatest benefit for the most of the population despite causing harm to a few individuals (Mandal et al. 2016).

The utilitarian approach is also known as the consequentialist approach where it assesses whether the actions are worth it by evaluating their consequences or outcomes. The focus under the approach is to maximize the greatest benefits for most of the individuals thus maximization of the collective welfare (Mack, 2004). By adopting the concept of the ends justifies the means; it views that ethics can only be guided or determined by the principle of utility. The application of the utilitarian approach by the healthcare institutions has resulted in the development of many policies and regulations. One such utilitarian policy is that when the there are two or more treatment methods available to a given patient that are equally effective, the focus should be the benefits of the patients rather than the cost of the treatment and risk associated with it (Mack, 2004). The care providers under the approach are therefore obligated to take an action that improves and maximize the health of the group or population as a whole. Another example of a utilitarian approach in the medical setting is allowing for the donation of organs or withdrawing the life sustainment system for patients in the permanent vegetative state.

There are various categories of the utilitarian approach. One such category is that of Karl Popper’s Negative Utilitarianism that advocates for least amount of pain for most individuals. Sentient Utilitarianism is another category advocating for equal consideration for all beings such as animals rather than just humans. Average, total, motive and rule utilitarian are other important categories of utilitarian philosophical approaches.

The deontological approach, on the other hand, involves ethics of duties where the morality of an action lies on the nature of the given action (Mandal et al. 2016). The ethical approach stipulates that it is not necessary for an ethical action to produce outcomes that may be viewed as good for the society or greater good. The policy is mostly applied during doctor and patient interaction with the goal of availing the best care available. The practitioners are driven towards offering the best care available failure to which issue of negligence may arise. Pressure by other parties such as healthcare professions, policymakers, and hospital managers increases the application of deontological approach in a healthcare institution (Playford et al. 2015). There are various categories of deontological ethical approach that include divine command, natural rights theory, contractarian ethics, and pluralistic deontology.

The utilitarian and deontological approaches can be applied together to ensure that medical ethics are observed across both approaches. The balance has been created as institutions try to create a balance between providing patient-centered care and society centered care services (Playford et al. 2015). Such is enabled when health practitioners use the consequences of a medical intervention are used together with the nature of the action to determine whether it is the most appropriate treatment for the patient (Garbutt & Davies, 2011).

The type of ethical approach adopted by a health institution affects the health system structure of the institution. The health system comprises of all individuals, institutions, and activities intended at improving, restoring or even maintaining the health of individuals. The ethical approach adopted by the healthcare institution, either deontological or utilitarian approach influences key building blocks of the health system. These building blocks include service delivery, the performance of the workforce, the information system, financing, and governance or leadership structure to be adopted.

Foundations of healthcare systems can also influence or be impacted by the choice of the ethical approach. When the culture, values, political environment and social norms do not align with some aspects of the healthcare provision that are provided by one ethical approach it is highly likely The that the approach will not be adopted by the institution.

The utilitarian approach has played a great role in shaping the Health Care Act that is popularly known as the Obama Care (Sorrell, 2012). The act aims at making quality healthcare services available to most of the Americans thus creating the greater benefit for most individuals. By adopting a utilitarian approach, the Health Care Act dictates the action of health insurance companies (Sorrell, 2012). One such way is by preventing insurance companies from hiking their rates in an unjustifiable manner. The Act provides for the insurance companies to offer coverage to individuals with pre-existing conditions. It can, therefore, be viewed as ethical with respect to the utilitarian approach due to the greater benefit.

The deontological approach affects the Health Care Act by insisting on both the outcome and action to be ethical. Obama Care requires all Americans to have the cover thus denying them the freedom of choice (Sorrell, 2012). By denying Americans the right to choose, the deontological approach can be viewed as unethical from the deontological approach.

The utilitarian and deontological ethical principles can impact the health-related services in the nonprofit sector in various ways. Utilitarianism impacts the health services provided by the nonprofit organizations through a number of ways (Sorrell, 2012). One such factor is by influencing the population health, which is the main aim of the organization. The utilitarian approach encourages the adoption of all approaches that improve the health of the larger population despite that negatively impacting the individuals (Sorrell, 2012). The actions of the organizations will be shaped in a manner that they promote health at the population level rather than focusing it at the individual’s level. Another way that will impact the non-profit organizations is by shaping their rules, policies, and regulations. The laws and regulations of the nonprofit organizations will be modified in a manner that emphasizes on the consequences of the action rather than the nature of the action to justify whether the medical intervention is legal (Sorrell, 2012). An example of a regulation adopting the utilitarian approach is that the practitioners should restrict resuscitation of the premature newborns based on the available time and resources to enable other receive sufficient care. Another example is that health practitioners should kill a person whose life at risk if it means saving the life of many other individuals who are at risk to maximize the greater good.

The deontological approach encourages the adoption of the ethical approaches claiming they are equally important as the consequences of the stated actions (Sorrell, 2012). The adoption of the approach impact health services offered by the non-profit organization by dictating the actions adopted in delivering those services. The organizational culture will also be shaped in a manner that advocates for attentiveness to details rather than entirely focusing on the results (Sorrell, 2012). The rules and regulations of the organization will also be modified to encourage attentiveness to process. An example of a law in adopting the deontological approach is that all individuals should be provided with the best available care service despite their criminal records.

Identifying the differences between the utilitarian and the deontological approach is an essential strategy in medicine as it distinguishes the morally correct actions from the immoral ones. The national debate regarding the healthcare act should adopt the utilitarian approach focusing on whether the current and proposed provision maximizes the wellbeing of the greatest majority. That can be ensured by providing a public healthcare system that provide health insurance to all individuals requiring minimal or even no pay from the pocket thus reducing the expenses to be incurred by the public (Naden, 2010). The option should offer basic treatment options that are limited when compared to the private option and longer wait time may be required while accessing healthcare services. With that provision, the public option will be a right for all the Americans while the expensive private option will be a privilege (Naden, 2010).

Recent researchers have pointed out that an increasing number of Americans believe that the government owes the people a responsibility to ensure health coverage. Despite conflicting views on the existence of private and public health coverage, 60 percent of American views access to healthcare as a right rather than a privilege (Bialik, 2017). However, there have been issues on how the existing healthcare act can be amended to ensure that healthcare coverage is afforded to all Americans.

The plans by the Republicans to repeal the American Health Care Act, also known as Obamacare healthcare system has been greatly affected by the lack of an alternative that offers similar or better benefits as the ones offered by the Obamacare system. Such a benefit includes the provision that the insurance companies cannot charge a higher premium on the basis of the medical history and neither can they deny such individuals health coverage. With an estimated 25 percent of the Americans having pre-existing conditions, the debate on whether to repeal will rely on the provision (Scott, 2017). By affecting an estimated 23 million individuals, the utilitarian approach can be attributed as the reason of the staloing of repealing of the Obamacare system (Scott, 2017). Republicans have been faced with the challenge of denying most of the Americans the benefits they were previously enjoying due to the provisions of Obamacare.

One of the main flaws of Obamacare is how the hike in the insurance rates of the employees affect the employer by laying a heavy burden on him to pay the premiums. The hikes present ethical issues as they do not signify a rise in the productivity of the employees and also make healthcare services inaccessible to unemployed individuals. Amendments should be made to prevent unjustifiable hikes by the private and public health insurers to ensure that all individuals can access best care services available.