Economic Forces Shaping Modern Healthcare Law - Essay Example

Economic Forces Shaping Modern Healthcare Law “Healthcare law is not in truth mainly about the rights of patients nor the duties of professionals. The main dynamic forces shaping modern healthcare law are economic rather than jurisprudential.” Discuss. The healthcare system in the United Kingdom is governed by the National Health Service under the administration of the Department of Health. This healthcare system relies on the income taxes of the people in order to provide free medical services for all. Our healthcare laws function to protect the rights of the patient. They help ensure that the patient has access to health care services and to have access to it regardless of his station in life. However, recently, it has been brought to the attention of some concerned parties how much economic factors affect healthcare legislation in the UK. They allege that healthcare legislation is now being determined, not by patient rights, but by economic elements. This paper will discuss how healthcare law is not in truth mainly about the rights of patients nor the duties of professionals; it will discuss how the main dynamic forces shaping modern healthcare laws are economic rather than jurisprudential. Healthcare Laws Healthcare laws are passed with the primary objective of protecting and advocating for the rights of the patient. In the healthcare sector, the patient is the vulnerable party; his condition often makes him a party susceptible to the whims of the healthcare system and the healthcare professionals. In order to neutralize this situation, healthcare laws are in place. These regulations cover rights such as informed consent, right to refuse treatment, right to confidentiality of medical information and such other similar rights. The right to informed consent has been discussed throughout the course as the right of the patient to be properly notified and clarified about the medical procedures that will be undertaken on his person. The risks of these procedures should be properly narrated to the patient in his language. The medical professional informing the patient should ensure that the patient has understood the medical procedures and all that these entail and imply. The right to refuse treatment in essence is about the patient’s choice and his right to refuse medical attention or to refuse medical procedures to be undertaken on his person. The right to confidentiality of medical information is about the right of the patient to be secure in the knowledge that what he reveals to the medical professional in confidence will be kept that way by the latter. Confidentiality extends to the patient’s medical records and the other medical procedures conducted on him. Other healthcare laws cover the conduct and behaviour of medical and healthcare professionals in caring for the patient. These healthcare laws were established in order to protect the patient and regulate the behaviour and conduct of healthcare professionals. They have set the guidelines by which healthcare professionals live by; they provide the patient with rights that he can demand and take refuge in. The Economic Forces Affecting Healthcare Laws Although the ultimate goal of healthcare laws is to protect patient rights, at present, economic forces are affecting healthcare legislation. Healthcare laws are being determined by the economic viability of the nation passing the law, not so much by the dictates and demands of jurisprudence. In the United Kingdom, the National Health System governs the healthcare system and healthcare legislation. The National Health System provides for free medical services for all. It is financed by the income taxes of the UK citizens. In present times when most of our lives are largely governed by the state of our economy, health care laws are now determined according to economic factors. Economic factors affecting health care legislation include the economic viability of the nation passing the law and the economic needs of the people where the healthcare law is to be passed. In the United States, economic instability is driving many legislators and interest groups to pressure the government and the healthcare sector for reforms in the healthcare system. They allege that there is a strong link between healthcare and the economy. Many Americans have no insurance coverage, and quite a lot of these uninsured individuals die annually because of the lack of direct access to health care. “Ultimately, Congress cannot help American families or address the economic woes ‘in a lasting, meaningful way without health care reform’ that includes an upfront investment in coverage and health care infrastructure (Shakir, et.al., 2008). These economic reforms cannot find firm ground without the help of legislation. The economic difficulties that the people experience in their lives make it hard for them to avail of adequate health care. And so, the United States Congress is often driven to create health care laws to provide for better access to quality health care for all, and to ensure that more people are encouraged to avail of health care insurance or other means to ensure adequate access to medical care. Health and Social Care Act of 2008 (Pregnancy Act) The modern trend in UK’s health care laws reveals traces of economic factors influencing the proposal and passage of these laws. The recent Health and Social Care Bill, more specifically the Health in Pregnancy Grant, made monetary provisions for pregnant women residing in the UK, setting aside £190 to help them achieve a healthy lifestyle and to assist them in the later stages of their pregnancy. Economic considerations in the UK have prompted legislators to consider helping pregnant mothers stay healthy while they are carrying their babies. The Health in Pregnancy Act is welcome news for pregnant women because it will help ease their financial worries during their pregnancy. “It also sends a powerful message that the health and well-being of the pregnant woman is crucial for a positive pregnancy outcome” (Warwick, 2008, as quoted by Midwives Information and Resource Service, 2008). This Act is one of the indicators to support the fact that the present health care laws are not solely about protecting the rights of the patient, but they are also affected by financial and economic considerations. Many expectant mothers with low incomes usually claim support during their pregnancy under the Sure Start Maternity Grant and under the Healthy Start Vouchers. The Health in Pregnancy Act is an additional means of helping them during their pregnancy. The Act is also tied in with the requirement of seeking medical advice from a health professional. This condition under the Act will help ensure that mothers seek medical advice during their pregnancy. This Act will help ensure that both mother and child are developing well. A healthy diet will help contribute to a healthy and well-developed child. It will also help reduce foetal abnormalities and defects that may create future problems, financial burdens, and complications to the families. Health and Social Care Act of 2008 (Transfer of Global Sum for Pharmaceuticals) The Health and Social Care Act of 2008 also made provisions for the transfer of the global sum for pharmaceuticals. The Act devolved the global fund to the primary care trusts. This enabled the primary care trusts to pay for the allowances of community pharmacists and for appliance contractors providing services. Economic and better management considerations have prompted the government to make provisions for the devolution of the global sum. “The global sum pays for services that are demand led, and local PCTs are better placed to manage pharmaceutical expenditure rather than the department” (Department of Health, 2007). The need to come up with an easier and a more economically viable means of managing the global fund has led legislators to make legal provision for the devolution of the global fund to the primary care trusts. This Act came again about not so much because of jurisprudence or from the need to protect patients, but because of economic factors and considerations. Health and Social Act of 2008 (Extension of Direct Payments in Lieu of Social Services) The Health and Social Act of 2008 also made provisions for the extension of direct payments in lieu of social services. Because of the economic need for individuals who were disqualified from receiving payments under previous legislation, the UK legislators made the necessary legal provisions to extend direct payments to them. This piece of legislation came about because the provisions of the Mental Capacity Act of 2005 disqualified individuals lacking capacity to avail of direct payments. Before the Health and Social Act, an individual must be able to give his consent in order to be eligible for direct payment, and people who lack the capacity cannot give their consent. However, it was argued by many legislators and interest groups that these individuals had the same (if not more) needs than the capacitated persons, and their mental incapacity should not disqualify them from receiving direct payments. Direct payments “offer individuals who are assessed as needing community care services opportunity to arrange their own personalized care, rather than receiving services directly provided by a local authority” (Department of Health, 2007). The Act was also passed because many legislators and interest groups saw the great need of young adults (and their parents) with learning disabilities, and enabled parents caring for these special young adults to receive direct payments even after their child turns 18 years of age. The 1989 Children Act previously prohibited parents from receiving direct payments when their children reached 18 years of age. “Extending direct payments to these groups of people will increase individuals’ independence by giving those most concerned with their welfare control over the way in which the services they are assessed as needing are delivered” (Department of Health 2007). Health and Social Act of 2008 (Abolition of Maintenance Liability of Relatives) The Health and Social Act of 2008 also abolished the maintenance liability of relatives. Before the passage of the act, spouses were made liable to maintain each other and parents were also made liable to maintain their children. It was within the rights of the local authorities to ask liable relatives to contribute to the cost of care their ailing relatives. This practice is no longer applicable in these modern times of divorce and where there is no longer just one breadwinner in the family. To apply this ruling in present times is patently unfair to the liable relatives. Present economic and financial changes have made this rule obsolete. Through the Health and Social Act, the local authorities no longer have the power to seek liable relatives for payments. “This will bring the operating principles for the charging policy for social care in line with those that are used in the rest of the health and social care system” (Parliament, 2007). These changes introduced by the Health and Social Act are necessary adjustments that have been set in place because of economic factors which are unnecessarily and unfairly suffered by liable relatives. Health and Social Act of 2008 (Power of the Secretary of State to Give Financial Assistance to Social Enterprises) The Health and Social Act of 2008 also created the power of the Secretary of State to give financial assistance to social enterprises. The increasing demand for quality health care services has prompted the government, especially its legislators to come up with reforms in the health and the social care services. This included ways of developing a provider market which is diverse. The need for more diverse choices for patients in their health care providers has also led to the creation of the social enterprise fund which acts as a business, the surplus of which are reinvested for social objectives for the benefit of the community. Many social enterprises had problems of health care delivery, social services, and business start-up. Legislators have now come up with the Social Enterprise Action Plan (SEIF) and the Third Sector Action Plan to “give stronger impetus for social enterprise development and support in the health/social care sector…” (Department of Health, 2007). The intention of the legislation is to assist social enterprises in their venture into health and social care. The SEIF aims to help in the development of social enterprises and social care by assisting them in their start-up costs, addressing gaps in information, and investments in order to encourage expansion into the health and social care sector. Through the Health and Social Act of 2008, the Secretary of State has the power to give support to social enterprises issuing health and social care and other related services. This assistance shall be provided through the Social Enterprise Investment Fund and is estimated to value about 73 million pounds in the span of four years. Many of the provisions of the Health and Social Act of 2008, as exemplified above indicate that economic forces increasingly affect the trends and the direction of health care legislation. They arise not solely because of jurisprudence, but more because of financial and economic considerations. These financial and economic factors are presently the driving forces behind these health care laws. National Health Service Redress Act of 2006 Another health care law which arose for partly economic reasons is the NHS Redress Act of 2006. The law came about because of the need to address the outcome and process of some lower value clinical negligence cases. Some patients and practitioners are often unnecessarily financially burdened by these cases. Their adjudication often takes too long, sometimes taking too much time and resources than is necessary, and diverting much needed time and resources from more important cases. The NHS Redress Act was passed in order to “provide appropriate redress, including investigations, explanations, apologies and financial redress where appropriate, without the need to go to court, thereby improving the experience of patients using the NHS” (Department of Health, n.d). Health Care Laws in Support of Childhood Immunization Many countries especially the lesser developed countries, have adopted into their health care policies provisions for the integration of compulsory immunization for infants and school-age children. Under the support of the World Health Organization, BCG vaccination and vaccination against childhood illnesses like Diphtheria, Pertussis, Tetanus, Hepatitis B, poliomyelitis, and other immunizable diseases have been required of infants and school-age children. In order to prevent the economic problems that these diseases may later bring to the childhood population, many countries have passed laws in order to compulsorily require mothers to have their children vaccinated against these childhood diseases. “Studies around the world and the assessment of the influenza vaccines conducted in Taiwan all indicate that immunization can reduce incidence and mortality of diseases, and save a large amount of direct medical care costs and indirect social costs” (Liu, 2000). Compulsory vaccination has not been completely accepted in the UK and the US because of concerns regarding the effectiveness and the adverse effects of these vaccines on children. However, it is undeniable that immunization laws have done their job in preventing the onset of childhood diseases in nations where it is mandated as compulsory. Health and Safety Offences Act of 2008 Poor health and poor safety practices have been seen by the government and various interest groups as acts that have put so much strain on the economy. It has been reported that health problems have been attributed to work injuries and ill health. Expenses for these work injuries have often proven to be difficult for many companies to shoulder. Lax health and safety policies in workplaces have also contributed to work injuries. NHS treatment for these injuries, including payouts for sickness and bereavement benefits cost the government millions of pounds each year. These costs can be reduced if proper safety practices are applied and religiously followed in the workplace. Recognizing this, the government has decided to pass tougher laws that will impose higher fines for health and safety violations. The Health and Safety Offences Act is set to take effect on January 16, 2009 in order to place a legitimate premium on violations of health and safety practices, especially in the workplace. This Act will help many companies reduce the incidence of injuries in the workplace and help save the government millions of pounds spent for the care of workers injured in the workplace. Fiscal Incentives for Pharmaceutical Companies The United Kingdom actively supports healthcare, and in order to ensure adequate funding for this sector, it has come up with provisions for fiscal incentives and investor-friendly policies to entice domestic and foreign investors. As a result, the pharmaceutical trade in the United Kingdom has become very lucrative for many pharmaceutical companies. Because of the growing need to make drugs more affordable and to be of better quality to the patient-customers, legislators passed laws to regulate the manufacture and sale of various medicines. The United Kingdom encourages the production of generic drugs by giving incentives to pharmacists and doctors who prescribe them. The aim of the government is to reduce health care costs, and in order to do this, they have deregulated some prescription drugs to over the counter (OTC) status. Clinical trials have also been encouraged by the government through tax incentives and investment policies. They have passed legislation to increase allocation for research and development in order to assist clinical trials. The country is also making strong efforts towards updating its healthcare system “in order to enhance the delivery of healthcare services and curb the rising healthcare cost” (Frost & Sullivan, 2006). At present, the country’s economy is being revived and with these improvements, investments and trade in the pharmaceutical products are likely to improve. The people’s purchasing power is also likely to improve because of efforts by the government to regulate and increase investments for pharmaceutical products and other medical supplies. Many interest groups opine that the government will not be able to meet the demands to increase funding for health care. However, necessary adjustments have already been made by the government in order to accommodate necessary changes in health care needs. The government is now gearing towards creating legislation towards increasing allocation for research and development, clinical trials, and new medical technologies. “NHS funded research has, for example, already shown that universal screening for prostate cancer would not be worthwhile and new approaches to prescribing in primary care are helping to deliver better care at lower cost” (Department of Health, 1997). The government has also recently decided to align clinical and financial responsibility to give healthcare professionals the chance to make the necessary financial decisions which are appropriate for their patients. Towards this end, the government has decided to “set a framework of national standards and will monitor performance to ensure consistency and fairness” (Department of Health, 1997). Budget Cuts in Health Care Services in California The modern trend in health care legislation in other parts of the globe is increasingly defined by economic factors and considerations. In California, Governor Schwarzenegger proposed budget cuts to the state’s health care allocation due to economic difficulties. Major health reform was also proposed in order to accommodate the reduced funding for health care. The Senate subcommittee overseeing the health and human services budget is on the process of hearing budget cut proposals that would require senior citizens to pay more and for low-income children to get less. If the Senate approves the proposal, it would deny about half a million lower income working parents Medi-Cal coverage. It would also eliminate dental, vision, podiatry, and other benefits for about 2.5 million parents, seniors, and people with disabilities. Funding for public hospitals would also be reduced (Quach, 2008). Health care laws has now become about what the state and the government can afford, not about what the patient needs, or about what he is entitled to by law. National Health Service Health care issues in the United Kingdom are affecting the delivery of health care services in member states. “The Member States are facing common challenges in delivering equal, efficient and high quality health services at affordable cost in times when the amount of care being delivered is starting to exceed the resource base” (Smyth, 2005). Health care demand in the United Kingdom and in most other parts of the world is increasing because of an ageing population and because of the world’s growing population. However, with the corresponding lack of increase in resources, these demands continue to be unfilled and unsatisfied. The National Health Services in the United Kingdom have been set-up in order to ensure that health care services are properly rationed to everyone who has need of health services. Before the National Health Services was set up in the United Kingdom, health services were only available to those who could afford to pay for health services. Now, the National Health Services with its succeeding amendments have been helping to provide services to everyone regardless of their station in life. The NHS was set up as a response to the people’s economic needs and their difficulties in availing of health care services due to economic constraints. “Areas that have greater health problems and are poorer are now getting more funding”, and consequently, inequalities in health care services are reduced by the NHS (Holtz, 2007). The NHS has also made provisions for rewards offered to physicians who reach population-based targets in disease prevention. Their contribution to the health care sector is invaluable because their efforts help in consequently reducing the cost of health care in the United Kingdom. The National Health Services also ensures that the cost of health care is the same for specialists and subspecialists. It has been undoubtedly noticeable for many specialists to charge more than their other colleagues in the medical practice. This has added to the burden of health care and hospitalization for the government and ultimately, for the patients. Hence, the government through the NHS has been set-up as a regulatory board or agency in order to guarantee that specialists and subspecialists charge the same fees. Policy changes in the National Health Service In 2003, taxes were increased and policy makers began to focus on making improvements in the health care system. Because of this tax increase, many changes in the delivery of health care services in the United Kingdom were made possible. These changes included: increase in the supply of nurses and physicians; increase in the in-service help for physicians and nurses and other health care professionals; specific goals set to reduce the incidence of many diseases, mandatory licensing for doctors every five years; health care providers rated by performance and results published as public information; health care funding directly given to primary care trusts; patients given choice as to their health care provider; NHS use of the diagnoses-related group (DRG) system to keep pricing for services regulated; NHS liability to the public for their budget, spending, and services. These changes which were introduced in 2003 were made possible because of increased taxes allocated for health care. Without this additional allocation, these changes would have had a difficult time being implemented. The health care sector in the United Kingdom is currently experiencing some economic difficulties. It seems that no nation is spared the effects of the economic crisis that is sweeping the world. It is affecting every aspect of our life-from our health care to our education, and to the rest of our social services. The modern trend in health care legislation is now about what the government and what the country can afford and follow-through to its finish, not anymore about jurisprudence and patient rights. Not to take away anything from patient rights because the protection of patient rights have served as the foundation of our health care laws, however, these rights are now taking the back burner to economic determinants as far as health care legislation is concerned. It is almost an expected phenomenon to later on anticipate that when our economic conditions will improve, our health care services and allocation will also improve. Indeed, the modern trends in health care laws are now determined by economic factors, not by jurisprudence. Works Cited Blackburn, P. & Laing, W. 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