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Organizational Responsibility and Ethics Paper HCS/545 June 21, 2010 University of Phoenix Organizational Responsibility and Ethics Paper Introduction According to the Census Bureau in the United States 41. 2 million American or 14% don’t have any “health insurance” in comparison “to 14. 2% or 40. 1million” for the year 2000. Therefore, of the uninsured population they are 28. 2% who are children’s and most of the populations are low income families and minorities. “In 1995, sixteen to nineteen percent of insured people were underinsured, meaning that they had decreased access to care an increased risk of out-of-pocket expenses. (Stroupe, Kinney, & Kniesner, 2000) Moreover, “91. 1million or approximately 1/3 of the population is uninsured or underinsured and the numbers “could be higher if not for the public program of Medicaid and State Children Health Insurance Program (SCHIP). ” (Shi, Oliver & Huang, 2000) In the past two years the numbers of uninsured American have increased because of the increase of unemployment and many families losing their health care providers. Therefore, with the shortage of health care labor and socio-demographics changes, that is occurring with the aging Americans.

This has created a large impact on the organizational responsibilities, which includes the resources allocations of human and financial. In addition, it causes ethical dilemmas within the organizations, like fraud, patient dumping, and transferring of information. Moreover, the health care labor shortage reports in January 2002 warn the organizations of how critical the shortage of available workers was in many states. Background: In the early twentieth century a well organized social movement started when Americans had a huge economic loss because of wages and increase medical care costs.

Therefore, in 1915 there was a campaign reform done for a “universal health care coverage and protections against the loss of wages” because of an individual illness. For example: •“The costs of lost earnings •The costs of medical care •Ethnic groups and minorities •Elder generation, 55 – 65 •Health care labor shortage •Ethical dilemmas” Furthermore, these issues cost not only affected individuals but also an entire society as well. “For that reason, reformers have pushed for a national system of health insurance for over a century, only to be met with fierce opposition from physicians and other interest groups. (Aftab H. & Patrick A. R. ) Therefore, health insurance wasn’t in place “in the U. S. ” until the end of World War II because companies and organizations could not attract new skill workforce. Political agenda: “Concerns include nursing and other work force shortages, a growing number of uninsured or underinsured patients, inadequate government payments, and uncompensated care. ” (Louann Kitchen, 2004) With the government in current alert because of terrorist attacks on U. S. soil have set their main priority on hospitals security issues and how they respond to a terrorist attack.

Therefore, insuring the public health care insurances is available and affordable for the public in an emergency situation is the government priority and political agenda. As the nurses continue to “play a huge role in the political process as they contact their elected officials in regard to issues” of their major concerns and how it will impact the public safety. (Louann Kitchen, 2004) New Health Care Legislative: Furthermore, though the managed care was introduced by the legislator to Congress in the 1970s as part of their initiatives.

In December 2003 a plethora of bills was introduce for a short period while congress was in session. In addition, in 2004 the legislative members introduce and amendment the just-enacted Medicare prescription drug bill, which primarily came from the democrats. (Mary K Wakefield, 2004) But with all of that they are new legislation in process to improve the health care system the country currently has. This has caused for various other programs funding to be cut as well as other assets that individuals and communities rely on.

The costs of medical care: As the country continue to reforms and balance out their objective goals with a competing market to access a high quality health care system. And with a “new health care system in place the costs to an individual, providers, government, and businesses should be reasonable, predictable and controllable. ” (Fixed for America) “As the health care system continue to rise” causing for organizations, small, and large business to struggle in maintaining a balance budget.

Therefore, with more organizations and business working together with doctors and health care providers who are working toward a wellness and prevention method to lower the health care costs. “As they can restore” the community trust between patient and insurance providers is imperative to maintain costs, improve the outcome, and reduction of unwarranted procedures as they reform the medical liability. Furthermore, with “40. 6M Americans who are uninsured: With more than 9 million been children; and more than eight out of 10 are from working families.

They are our friends, neighbors, forced to gamble daily hoping they won’t get sick or injured. ” (Robert W. Johnson, 2009) In the last 10 years the health care privacy protection act was passed by the Federal government for the protection of patients records. Therefore, the patient’s medical records are confidential; under state law, and with the exception of a “health related issues within the organization, responsible parties cannot release the records or any information therein without the consent of the patient. ” (Eleanor D. Kinney, 2001, p. ) “And with the previous changes made in the late 80s and early 90s of the finance and delivery of health care to make sure that Americans would have a prepaid capitated health plans called “managed” care. ” (Eleanor D. Kinney, 2001, p. 4) Therefore, after the introduction of the managed care, it created a competitive approach for the health “care system with a delivery of care” to the population. “As they incorporated the health Insurance portability and accountability act in 1996 (HIPAA) as Congress recognized the need for a national patient record privacy standards. ” (Eleanor D. Kinney, 2001, p. 9) Ethnic groups and minorities:

The racial attitude and discrimination in the entire United States toward people who has insurance and those that don’t regardless of their ethnic background would come to a halt. Because the entire U. S. population “would be entitle to the” same insurance policies that are currently available for the rich and wealthy as well as for the poor. This still wouldn’t totally eliminate racial attitude or discrimination because these disparities would probable continue in the “mortgage lenders, housing, and employment practices as they use paired “testers,” which consistently demonstrated discrimination against African Americans and Hispanics. (Agency for healthcare research and quality, 2001) Further, this would be beneficial for every American family regardless of their economical status, where it would permit them to receive the required health care they need without the stress of been discriminated. In addition, an individual whether they are an African American family, Hispanic family, or Italian family, it wouldn’t matter what are their ethnicities are because they would receive the same treatment at the hospitals. Elderly: An aging population, together with rising health care costs and rapid health system change, presents a major challenge in the delivery of health care to older Americans” (John M. Eisenberg, M. D. , Director of AHRQ). “With the constant changing composition of the older population, this increased the pressure on the health care system” (John M. Eisenberg, M. D. , Director of AHRQ). By the year “2011,” they will be an approximate of 77million baby Boomers that will “turn 65, and by 2025, the number of Medicare beneficiaries are expected to rise to 69. million” (John M. Eisenberg, M. D. , Director of AHRQ). In addition, these people will represent a 20. 6% to be “of the U. S. population, with the “old and older” to be over the age of 80, which are comprised as one of the fastest growing segments of the population” (John M. Eisenberg, M. D. , Director of AHRQ). Therefore, because of the demographic trends, there is a huge concern on the increase of health care costs for the elderly population consistently growing at an alarming rate. Health care labor shortage:

There is a major shortage of available labor across the country in various health care occupations. Moreover, this shortage majorly has jeopardized the quality and availabilities of health care workers through many states. Therefore, “the health care industry provides about 6. 2 billion in wages during the year of 2000. In turn, it is almost twice as much as agriculture, forestry, and fishing combined. ” (Sue Skillman, 2001) In addition, “between 2002 and 2008 there should be over 6000 jobs openings throughout the health care industry each year. (Sue Skillman, 2001) This has caused for other organizations and businesses that would prefer to grow in certain areas within the communities to offer better health care. In states of Washington they are a huge health care shortage of workers, which has created a crisis level in the organizations. “In this present crisis the health care shortage includes nurses, medical aides, dental hygienist, billers and coders, laboratory personnel, pharmacists, physicians, and radiology technologists. (Sue Skillman, 2001) In addition, the state of Washington reported a shortage of experience nurses of an approximate of 2,200 workers during the 2001 year. Furthermore, the recruitment of qualified and experienced workers has created major challenges. In turn, “they are 79% continue to have major difficulty in recruiting newly trained register nurses throughout the year of 2000 and 2001, and more than 95% had major difficulty hiring experience workers. (Sue Skillman, 2001) Whereas, the organization has other objective and strategies as the increase in the number of students: in the health care workforce, increase availabilities for clinical training, remove barriers for training new and old health care personnel, recruit diverse groups of people within the health care profession, including gender, race, ethnicities, age, and disable. With organization taking the time to increase retention rate of qualified health care workers and their availabilities will give the younger generation awareness of the opportunities that are available within the health care workforce.

In addition, of providing the appropriate counseling in the school system and permit the communities to address the health care shortage within each corresponding states or counties. Support of national safety net: They can be several “financial and structural pressures on the nation safety net. ” (IOM, 2000). In turn, they can be various possible changes in policy “that could be implemented by relieving the pressure and address several of the” issues presently (IOM, 2000). Thus, the effect of the Medicaid policy needs to address.

Further, the “Medicaid managed care has shift the Medicaid patient away from the safety net providers, which has created a serious change in their revenue streams” (IOM, 2000). In addition, with the changes that has occur has forced the safety net to adapt because of the large decrease in revenue, and with no federal aid to assist or any “pressure placed on managed care can possible harm the ability of these groups to function” accordingly. (IOM, 2000) Tax Credits: They are various organizations who “have supported the implementation of employer tax subsidies to initiate and expand coverage for low-wage workers” (Hellander, 2001).

Moreover, “this proposal has encountered criticism for the limited amount of uninsured, which would be covered (less than 50%) and for the benefits it would provide to private insurance companies” (Hellander, 2001). Innovative State Health Programs: “Georgia: The Community-Based Alternatives for Youth (CBAY) program allows severely mentally ill children to remain with their families or in their communities as an alternative to living in a residential mental health facility, explains Virginia Dick” (Carl Vinson, 2010).

This innovative evaluation research is being carried out in 15 northwest Georgia counties and in Chatham, DeKalb, Fulton, Gwinnett, Rockdale, and Newton counties by the departments of DBHDD. “Maine: Coverage expansion to adults without dependent children was implemented in 2002” (Sharon Silow – Carrol and Tanya Alteras, p. 18, Oct. , 2004). In addition, “through an 1115 HIFA waiver, Maine is transferring unused DSH funds, supplemented with tobacco-tax revenues, to finance a Medicaid expansion to adults without dependent children” (Sharon Silow – Carrol and Tanya Alteras, p. 18, Oct. , 2004).

Therefore, the program covers adults who have income at 100% FPL, which are eligible, and since June 2003 they have being over 15K adult individuals who has enrolled in the Medicaid program due to the expansion. Ethical dilemmas: “Presently most hospitals have an ethics committee. ” (Paul F. Johnson, p. 1, 2006) Therefore, the hospital has review accreditations, which are “conducted under the auspice of the Joint Commission on the Accreditation of Health care Organizations (JCAHO). ” Further, they do not have a specific requirement for regular meetings to review the Medical Ethics 395.

This committee is well-situated ethics committee, which goes forward in “demonstrating compliance with JCAHO regulations, and insuring the various indispensable benefits that comes from an accredited organization. ” (Paul F. Johnson, p. 1, 2006)They are various Habermas features that are relevant in a “contemporary medical ethics that places the organization in the appropriate direction. ” (Paul F. Johnson, p. 1, 2006) Other ethical dilemmas in the medical community are the “right to die were Karen Ann Quinlan case ushered the “right to die” era, which includes the use of a living wills and advance directives. (Thompson R. E. , p. 1, 2006) Because the courts made the assumption that every hospital had an ethics committee within their organizations. Moreover, the caused for a “development of a requirement of a Joint Commission that every hospital develops an organization or mechanism to deal with ethical dilemmas, even when JCAHO” do not actually require the hospital to have an ethics committee. (Thompson R. E. , p. 1, 2006) In addition, they are conflicts with other medical issues as the use of embryos for stem cells researches in the assisting disable people to walk again and many other possibilities.

Further, it has caused tremendous issues within the religious communities and moral ethics were the government had to intervene and place a halt in the use of these research. “Although patients have the “right to refuse medical treatment” cases have trouble terminating their medical care, many persons have trouble obtaining medical care in the first place because they are refused admission to hospitals and these are called patient dumping” (George P. Smith, II, 1998). But with patients encountering financial difficulty they can be let go by doctors or therapist or transferred to another facility because of their situation.

With hospital been overwhelm with patients at times the billing department encounter problems when they are billing the insurance companies or other organizations and incorrectly enter the wrong code for the treatment provided to the patients and this can be constitute as fraud. (Deborah Smith, 2003) In conclusion, with the current issues within the health care system and for various decades the country has been doing their best to come up with a health care system that works for every American person.

But through the years the solution for resolving the high costs increase of the health care system has been difficult for the government to regulate. Furthermore, with some of the population in favor to have a health care system that works for everyone and other against possessing a national health care system. Furthermore, with the shortage of health care labor, and socio-demographics changes that is occurring with the aging Americans. This has created a large impact on the organizational responsibilities, which includes the resources allocations of human and financial.

Additionally, it created an ethical dilemma within the organizations, as fraud, patient dumping, and transferring of information. As with the labor shortage reported in 2002 warns the organizations of how critical the shortage of available workers is in many states today. Reference: Aftab Hussain and Patrick A. Rivers, PhD, MBA, Policy Challenges in US Helath Care system Reform, Retrieved on April 18, 2010, from Journal of Health Care Finance/Spring 2010;36(3):34–46, © 2010 Aspen Publishers Agency for Healthcare research and Quality, (2001).

Addressing racial and ethnic disparities in healthcare from www. ahrg. gov/researh/disparit. htm. com Carl Vinson, Institute of Government, University of Georgia, (2010). Evaluation Sheds light on effectiveness of Innovative Health Program. Retrieved from http://www. cviog. uga. edu/spotlight/335_Evaluation-Examines-Effectiveness-of-Innovative-Health-Program Deborah Smith, (2003). Monitor Staff American Psychological Association, cover story. From http://www. apa. org/monitor/jan03/10ways. aspx Eleanor D Kinney, (2001).

The brave new world of medical standards of care, The Journal of Law, Medicine & Ethics; Fall 2001; 29, 3/4; Research Library Fixed for America, Solution start Here, (When Healthcare is fixed for small business it’s. ) from http://www. fixedforamerica. com/content/? id=293 Hellander, I. A review of data on the health sector of the United States. International Journal of Health Services 2001; 31 (4): 823-846. John M. Eisenberg, M. D. , Director of AHRQ. Improving the health and health care of older Americans.

A report of the AHRQ task force on aging. Aging-Related Health Services Research: Rationale. Delivering health care to an aging population. Retrieved from http://www. ahrq. gov/RESEARCH/olderam/oldam1. htm#rationale Johnson, P. F. (2006, Summer). Preserving our values: Habermas, hospital ethics, and the business of health care. Midwest Quarterly, 47(4), 393. George P. Smith, II, (1998) The Elder Law Journal. Essay Patient Dumping Implication for the elderly. Retrieved from

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