Abstract The Affordable Care Act was signed into law in March of 2010 by President Obama, these set of new laws and regulations is designed to provide ethical changes to a fragmented health care system. Cultural bias and social stigmatism have hampered the acceptance of such sweeping changes to the American health care system. Culturally some Americans feel they are handing over their health care choices to government control, socially some Americans believe that the government it reducing free trade, taking control of health care and limiting capitalism in the health care market. This argument is to disprove those stances hoping to provide an outline of what Americans should accept as reasonable ethical, cultural and social changes to a system that was, and is, still fragmented in many ways. There have been many changes to the health care system thus far, but there are many more that need to take place. It is no longer ethically acceptable to just meet the medical needs of Americans, but to pursue greater levels of standards of care practices for those in need. Ethically it is time for Americans to start to question some of the cultural and social “norms” I believe and start to be more socially responsible for themselves and others regarding the health care system as a whole. By following this outline and looking at the examples I think that many Americans would agree that this would be an easy task to accomplish, it may take us as a society out of our comfort zones, but it is time for us to change our way of thinking.
Changing the System
According to the Institute of Medicine’s report brief, Crossing the Quality Chasm: A New Health System for the 21st Century 2001, there are several methods to reinvent and improve the delivery of care at healthcare organizations. Improvement must begin somewhere; health professionals, federal and state policy makers, private and public care purchasers, regulators, managers of organization’s and governing boards and the consumer. These persons, individually or as a group, should be working toward “continually reducing the burden of illness, injury and disability to improve the health and functioning of the people of the United Stated,” (IOM, 2001). The vision consists of six different improvement aims: safe, effective, patient-centered, timely, efficient and equitable. Patients will have a safe, reliable, integrated and more available response to their needs if all six areas are heeded. Increased satisfaction can be met in preventative, acute and chronic services and will have improved health, longevity, less pain/suffering and fulfilling productivity. During the redesigning process, ten rules or principles can be utilized to help achieve the six improvement aims. When redesigning occurs challenges such as reengineering the care process, effective use of information technologies, skills and education management, effective teams and coordination of care (conditions, services, sites) are addressed to make change possible. Principles to include:
Care is based on continuous healing- Care is received whenever needed and not just in person; accessible via internet, telephone, etc…; and at all times.
Care is customized (consider patient needs and values)- Systems designed to satisfy most common types of needs, with capabilities to respect individual patient choices and preferences.
The patient is in control- Patients receive proper information and opportunity to make personal, appropriate healthcare decisions. Shared decision making should also be encouraged.
Medical information is shard- Patients have access to their medical information. Communication between medical staff and patients is effective, common information.
Evidence-based decisions- Best available scientific information dictates care received. Care should be similar from place to place.
Safety is priority- System risk, injury or death is reduced; ensuring patient safety