After the Affordable Care Act (ACA) was enacted in 2010, United States experienced of market changes in the healthcare field. The traditional authority, responsibilities, and roles of many stakeholders in the country were put to test and where necessary changes were implemented. The ACA Act was designed to ensure that all Americans could be protected from unfair pricing of healthcare services and medication. However, the country is noted for its conservative capitalism and most of the stakeholders felt that the Act was heading the country towards the socialism ideology, and this opposition ensured that some states did not accept the proposal to ensure that the country had universal coverage. In order to analyze the effect of health reforms, it is imperative to look at relationship between health reforms with policy formulation, economic and ethical challenges.
In the United States, the stakeholders including the citizens, healthcare practitioners, physicians, doctors, pharmaceutical companies influence policy formulation. In the same respect, it is imperative to note that any policy is passed through an Act enacted by the congress. However, the interests of the different stakeholders are usually at conflict, which leads to lobbying within the field and in the congress by different interest groups (Schoen, 2016). For instance, when considering the costs of prostate cancer medication as highlighted in the Washington Post, the pharmaceutical companies are interested in maintaining or increasing their profit margins, while other stakeholders like the patients want high quality medical services in an affordable manner. This scenario presents policymakers with an ethical dilemma because whereas the population that is to be protected from costly drugs needs high quality drugs, there is the possibility that enforcing pharmaceutical companies to lower their prices will compromise the quality of drugs offered to the patients.
Economically, it is obligation of the government to ensure that its citizens welfare is safeguarded. This implies that the government is legally obligated to enhance the affordability of healthcare. The ACA health reforms were designed to ensure that the country adopted a healthcare system characterized by universal coverage. Many developed countries have universal coverage and their economies have not been adversely affected by the health system. However, some of the opponents of the Affordable Care Act argued that people from higher income households would bear the burden of insuring the people form lower income households. However, five years into the 2010 healthcare reforms, analyst did not find any adverse negative effects to the economy of the country. In the same respect, it is important to note that the reforms did not have any effect on employment rates of the country (Santilli & Vogenberg, 2015). However, when the Supreme Court ruled that states should independently decide whether to ensure universal coverage, some states declined to implement the Act.
This decline presents the issue of the reforms and the ethical consideration of some of the states. Implementing the policies of Act had ethical dilemmas to the policy makers of different states in the country. For instance, it is not ethical to subject some people to carry the burden of paying for the healthcare of other people, a factor that led to much debate about the ACA implementation. Most of the states did not want to be viewed as favoring the low-income citizens over the high-income citizens on the basis that implementing these policies would mean that the wealthy people would have their taxes used on the healthcare and wellbeing of the poor in their society. It is also important to note that the government is ethically obligated to ensure that even the poor people are offered opportunities of accessing affordable health (Bagley & Levy, 2014). This ethical dilemma resulted with some states adopting the policies of ACA, other declined, and others are still not decided. Other aspect of health policy and associated ethical dilemma is that policymakers have to balance between the interests of all stakeholders. For instance, according to the Washington Post article, there is a relationship between the cost and quality of the drugs offered by pharmaceutical companies for prostate cancer. Policymakers cannot ethically pass laws that will harm drug making companies, which are also a significant contributor to the economy while at the same time they must protect prostate cancer patients from being abused by unscrupulous pharmaceutical companies.
Bagley, N., & Levy, H. (2014). Essential health benefits and the Affordable Care Act: Law and process. Journal of health politics, policy and law, 39(2), 441-465.
Santilli, J., & Vogenberg, F. R. (2015). Key strategic trends that impact healthcare decision-making and stakeholder roles in the new marketplace. American health & drug benefits, 8(1), 15.
Schoen, C. (2016). The Affordable Care Act and the US economy: A five-year perspective. Commonwealth Fund.
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