As I continue to work through the readings each week and read about the different ethical scenarios it’s very clear that the underlying source of many ethical dilemmas in health care is due to the fact that health care is a business and it’s also meant to serve the community. Many of the examples in the two books we are studying are meant to highlight the difficulty of running a business (especially a for-profit business) in an industry where people expect that society will be supported first and profits second.
I am a business owner of a health consultation company and I found the perspective of “cherry picking” in advertising on the part of Managed Care Organizations (MCOs) to be very interesting. The point was that MCOs should not solely seek out healthy individuals that have a low probability of needing coverage.
I thought to myself, “Why wouldn’t they have that approach? It’s the most profitable way for them to run their business?” And frankly, I’ve never thought of MCOs as being organizations that have the greater good of the people at the forefront. But, why are MCOs expected to advertise their services to everyone and other health care businesses don’t have this same expectation?
For example, is anyone keeping tabs on who walk-in clinics are advertising to? What if they aren’t marketing enough to underprivileged markets in their area? Is it wrong if they target upper middle class families for their services and not others? What if that makes the most sense for them from a business perspective? It’s important, after all, that they do stay in business.
What I find is that certain public interest groups expect organizations like big MCOs, pharma companies and other for-profit organizations to behave as if society’s wellbeing is their first priority. However, for the most part these organizations operate with the primary motivation of making profits and helping society is second, third and sometimes last on the list.
Should society expect these for-profit organizations—multi-billion dollar companies with their shareholder interests to operate with the wellbeing of society as first priority? Personally, I think it’s silly to keep expecting that.
Now, I don’t mean to say that companies should be given free rein to do whatever they want. There are certain boundaries that need to exist—drugs still need to go through clinical trials and there should be regulations about the claims that companies can make about what their products do and what they are indicated to treat. However, I don’t think people should keep expecting big MCOs and big pharma to start acting like Mother Theresa.
With all of this in mind, I wonder if the best thing we could do is to have a socialized health care option such as the one that President Obama has proposed. Now, I’m not saying that the bill is flawless and it may be a total flop in the end. However, it seems that society is expecting for there to be more health care institutions that have their interest in mind and not profits as first priority.
I know that the government can really make a mess of things if they get too involved, but I’m starting to wonder if the reform is exactly what the country needs. What if, on an ethical level for the citizens of America there was a place that everyone could go to get covered for health care? And the organization that provided it didn’t have the pressure from shareholders or any other for-profit objectives that private health organizations have? It’s not a perfect model, but maybe it’s better than the one that we have. It’s all theory, but it will be interesting to see what happens.
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