In terms of economics, all resources are deemed to be scarce. This is taken into consideration during the process of policy decision-making. The ethical predicament or problem is how to strike a balance with the principles of independence, benevolence, and distributive justice. The aspect of allocating or rationing might have an impact on three scopes of health care coverage. These are the size or fraction of the population that is covered, the kind of services that are given coverage, and the magnitude or extent to which these particular services are covered (Teutsch and Rechel, 2012).
Statistics show that the United States spends fifty percent more per capita for the provision of health care in comparison to any other nation in the world, while at the same time attaining poorer and inferior health care quality than many. According to Teutsch and Rechel (2012), due to poor mechanisms in coverage in terms of cost effectiveness cause about nineteen percent of the population without health care coverage. Up until the health care reform of 2010, which passed the Patient Protection and Affordable Care Act (PPACA), health care was considered to be a source of pride and not a fundamental right.

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In accordance to Reinhardt (2010), the U.S. health care reform bill makes and attempt and endeavors to achieve better value for the U.S. health care dollar by generating more research into cost-effective care. This is to ensure that the highest level of quality of health care in the world can be affordable to all households in America. Essentially, it implies considerable federal subsidies to assist lower-income households attain private or public health insurance. It also implies in terms of policy decision-making, there has to be a bending in the cost curve which implies decreasing the yearly increases in national health spending (Reinhardt, 2010). Kovner and Knickman (2011) outline the way in which the health care reform might impact the financing system. For instance, individuals in households that earn 133-400% of the poverty line, which is decided on the federal level, will attain considerable subsidies to facilitate them to buy coverage by means of an insurance exchange that will tie the private insurance providers to the eligible individuals. The new law necessitates that insurance companies offer coverage to all individuals even those who presently have health care issues. This implies that insurers will face restrictions on how much they will be able to charge for administrative expenses. In addition, the law encompasses a number of provisions that will alter and transform payment policies so as to generate incentives for providers to improve the quality of health care and also the value of health care services rendered.

However, the notion of attaining cost effectiveness and the decisions that are thereafter made do have an ethical impact in turn. According to an article written by Stein (2010), federal reviews undertaken to ascertain whether Medicare expenditures should be allocated to an expensive prostate cancer vaccine does present a number of ethical issues. In as much as Medicare is not supposed to take cost into account when implementing such rulings or verdicts, the resolution to present an official analysis and consideration does create several concerns amongst different stakeholders such as medical experts, drug corporations, policymakers, the medical patients and advocacy groups. The decision made has a great effect for because the resolution undertaken by Medicare is usually followed by Private insurers as well (Stein, 2010). The ethical impact is that considering the cost-benefit ratios might be beneficial for cutting costs and might be good for the providers of coverage. However, this might cost the lives of people considering that the approval of the drug or medication policy could enable the patients to live much longer than anticipated.

    References
  • Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (Laureate Education, Inc., custom ed.). New York, NY: Springer Publishing.
  • Reinhardt, U. E. (2010, Jan 20). State of the nation (a special report): Voices—A good start. The Wall Street Journal, p. R5. Retrieved from the Walden Library databases.
  • Stein, R. (2010, November 8). Review of prostate cancer drugs Provenge renews medical cost-benefit debate. The Washington Post. Retrieved from: http://www.washingtonpost.com/wpdyn/content/article/2010/11/07/AR2010110705205.html
  • Teutsch, S., & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal restraint US and Europe. Public Health Rev, 34, 1-10.