Essay Short Answer Questions: Health Care

Question 1: Both Japan and Switzerland appear to take the most ethical approach to their health care out of all nations, it could be argued. This is because, from an ethical perspective, the health care systems of these two countries are the fairest. In Japan, for example, the patients themselves are only responsible for paying a small part of the total health care bill, with the government covering the remaining bill, usually paying about three-fourths of the bill (Ikegami & Campbell, 1999). This health care system is more ethical than one that takes one extreme or the other because it allows citizens to be able to afford their health care while also charging them enough to keep their tax rates for it relatively low (Ikegami & Campbell, 1999). This is not the case in Switzerland, which utilizes a much more socialized method of health care, quite similar to the recent "Obamacare" in the United States, with citizens requiring a basic form of health insurance at all times, and receiving free or largely reduced bills because of it (Mackenbach, 2006). This causes a slow burn, of sorts, with citizens shelling out a large amount of money for health insurance each month but avoiding the sticker shock of large hospital bills. Nevertheless, this represents the second ethical aspect of these health care systems: a willingness to avoid immediate financial setbacks instead of equally damaging, yet much slower, financial drain in the form of this mandatory health insurance.

Question 2: The most prominent aspect of Great Britain's health system that would benefit the United States is a centralized health care unit, which, in this case, is the National Health Service, which oversees several other departments responsible for administering health care, such as the Strategic Health Authorities (Mackenbach, 2006). This creates a unique government entity that is focused entirely on health care in the nation, which the United States currently lacks, instead opting to segment the health care process into many private insurance companies and hospitals, which creates several complications when the time comes to receive health care. The NHS in England also represents an extreme simplification of the health care system, which is ethically sound because it allows the citizens to more easily grasp and use its services than the chaos that is the American health care system. Finally, having a centralized health care entity allows for a much more organized system of funding, including a linear chain of funding from the government down to the citizen, with no complicated third parties needing to intervene, in most cases (Mackenbach, 2006).

Question 3: One ethical strength of the United States' health care system is its versatility. Allowing patients to choose their insurance provider as well as hospital and method of payments allows for a great deal of freedom regarding health care for its citizens (Kongstvedt, 2012). Another ethical strength is that it is tailor-made to allow those with lower incomes to have access to competent health care, especially after Barack Obama implemented the Affordable Care Act (ACA) in 2010 (Kongstvedt, 2012). This allows the system to truly offer health care for all, even if it causes the system to become somewhat more socialized in the process. This brings up the first ethical weakness of the health care system of the United States: its forcing of health care upon those who might not need it. The ACA, while it allows health care for all, also requires everyone to have health insurance, even those who might not need it, such as the very young and healthy (Kongstvedt, 2012). This creates an ethical paradox of sorts, wherein citizens are free to choose their health care providers, hospitals, etc. but not the underlying fact that they must have health insurance. The second ethical weakness of the health care system is an overall lack of standards within the hospitals and, to a degree, insurance companies. Although many of these companies are approved by the government, there are still many hospitals that simply do not give care on the same level as others, oftentimes causing those with less income to receive poorer quality care, potentially causing more problems in the future and eliminating the advantage of the ACA in the first place, which was to allow lower-income citizens access to competent health care.

References

Ikegami, N., & Campbell, J. C. (1999). Health care reform in Japan: The virtues of muddling through. Health Affairs, 18(3), 56-75.

Kongstvedt, P. R. (2012). Essentials of managed health care. Jones & Bartlett Publishers.

Mackenbach, J. P. (2006). Health inequalities: Europe in profile. Produced by COI for the Department of Health.