Running head: HEALTH POLICY VALUES
Health Policy Values
Claudette D. Johnson
Grand Canyon University
NUR-508 Ethics, Policy and Finance in the Health Care System
June 6, 2012
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HEALTH POLICY VALUES
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Health Policy Values
Introduction
A person’s health can shape a society and health is the central indicator of the social
value of a society (Browne, 2001). The World Health Organization (WHO) Constitution (1946)
first reflected the concept that the right to health is the highest standard of health (Browne,
2001). This paper will be reflecting on the author’s personal values and beliefs; the effects of
beliefs and opinions on health care policy as it relates to cost, quality and social issues; how
factors such as family upbringing, spiritual or religious beliefs/doctrine, personal and
professional experiences, and political ideology affect your current perspective on health care
policy; and discuss inconsistencies in aligning personal values and beliefs with current health
policy.
Describe your personal values and beliefs.
This author’s native country is the Philippines and migrated to the United States of
America at age12. Raised in a middle class, conservative, Catholic household, my younger years
focused on school, dance, music and church. My dad moved to the U.S. after 5 years of waiting
and after he became a citizen, petitioned the rest of the family; wife and 6 children.
As practicing Catholics, God was the source of strength, attended mass every Sunday,
went to Catholic schools and observed all the Holy holidays. In our teen years, they encouraged
us to make choices about church involvement with some of us now not as devote as others. I am
a believer but not obsessed if church does not happen on Sundays. My belief in a God has not
changed but my outlook on Catholic values has evolved. Abortion was not uttered in our
household but as we grew older understand circumstances that can lead people to choose
abortion. I am more open-minded. My concept of spirituality is that it is about finding the
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balance of values and morals as we take into consideration the benefits to society. I have been
told to be analytical and an over thinker.
Work ethics and education are high in the agenda in our household. We all started
working at the age of 16 and my parents only rewarded 2 things: good grades and good deed
(what they called unselfish acts). Professionalism, reliability, optimism and ability to find the
balance between homes, work and school life are values this author takes pride on. Working hard
and earning my pay are work ethics instilled by my parents. My upbringing has taught me to be
willing to help and being respectful of the laws. My parents have often stated that “opportunity
will not come to you; you will need to seek it out”. I value sincerity and the truth (it may hurt
but it will hurt worst if one would find out later).
Beliefs and opinions about health care policy
Healthcare is needed by everyone and the price of healthcare is not cheap. The cost for
maintaining the health of Americans does not come without a price. I believe the cost of caring
for our citizens will either be paid upfront by taxation and promotion of health behaviors or later
by the cost of medical care for disease complications. As Americans we need make a decision.
However, our government also needs to do self-examination of internal processes to ensure
efficiency. People will not mind making concessions in their daily lives if the government is
doing the same. Economic irresponsibility
Quality of healthcare is a constant concern. Supporters and opponents of health care
reform legislation agree that the current growth in health care costs is unsustainable (United
States Department of Health & Human Services, 2012). The rationale is that preventive
strategies and timely care will lessen illness and lower costs in the long run, but my fear that
expanded coverage will only increase the national debt and Medicare and Medicaid and private
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insurers, will seek to control spending by rewarding the quality rather than the quantity of care.
Under the reformed system, Medicare payments will be tied in part to the quality of care
provided, with bonuses given to hospitals and physicians that produce the best outcomes and
value for their patients (United States Department of Health & Human Services, 2012). This
necessitates hospitals to be more devoted to finding more efficient ways to render quality care. I
believe quality is what hospitals should always strive for; mandating can create gaps in
healthcare access.
I believe as nurses, investment in legislative as well as practice advocacy is a necessity.
Health care reform, with its emphasis on rewarding quality and cutting costs, could change the
medical care landscape of care is delivered in the U.S. and how we measure quality takes on new
urgency. Standardized benchmarks for excellence, quality measurements will have a powerful
impact on how we realign our health care system. As nurses, we need to take a lead in finding
creative ways to render our care. Inefficiencies in managing supplies and treatments and care
should be improved or the status of hospitals and our careers will be compromised.
The debate on health is in terms of wealth and economic growth (Browne, 2001). The
dispute that monetary progress leads to health implies that an economy needs first to grow and
before investing in health. Though others may think that the US has a moral as well as a
financial obligation globally (seen by other countries as rich in resources), we also have financial
obligations to our own people. In a country so rich, it is hard to understand why we struggle
with helping our own. Yet we are used to going to other nation’s aid, partly due to our efforts to
maintain the superpower image which in itself has its advantages. More importantly, we are
seen as the land of opportunity, with credibility around the world as one who will be fair and just
and especially herald to have strong moral values. Holding up to our end of this bargain is not an
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issue as long as people, who respect our freedom, also respect the laws we are all accountable to.
It is when exceptions are made to those who do not follow the rules that people feel fairness has
created a double standard. People are willing to share the cost if they are all financing the cost
equally.
As a nurse, it is an agonizing dilemma; for caring is the focus of our careers. As a worker
in a community hospital, it is even more difficult for even if your heart says no to under
privilege, and illegal Immigrants. As one who came from a foreign land, I will say, everyone
needs to be legal. As tax payers contributing to the future of my children and to my future care, I
have to say we must set limits before they get here. If they set foot in our land and get sick here,
it becomes our obligation to now fix the problems we created to occur. Yet we can set limits and
enforce the laws we created to preserve our future and our children’s future. Selfish as it is, our
nation is struggling to make it (be it our fault due to mismanagement or our inefficiency as a
whole). Unlike Risse (2008), who “argues that because resources are not distributed evenly
around the globe, it is unjust for those with the good fortune to be born in resource-rich areas like
the United States to exclude others from less well-endowed areas from entering the United States
to share the wealth, I will add share the wealth after we take care of our own and that includes all
who legally immigrate to this country. For if we have the wealth and the means, I am all for
sharing but our health care crisis jeopardizes the health of our own countrymen and to me that is
what is unjust and unfair.
Although health as human right is articulated in every meeting discussing health, the
approach to health largely contradicts the principles of human rights. Indeed if health is a human
right, then ensuring peoples’ health is by definition a direct responsibility of the state.
International aid for health can be debated from many angles, especially if considered from the
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human rights-based approach (Kaiser Family Foundation, 2003). It focuses on individuals and
blames them for their irresponsible behavior. This authors feels there is joint responsibility and
now is not the time to finger point when individuals are suffering – patients without coverage
and hospitals with less reimbursement.
Spiritual beliefs impact political ideologies and the policy process
America is not only the most secular society in the world; it is the most individualistic
(Kaiser Family Foundation, 2009). Spirituality defines a more global view of life’s meaning
(value of life, peaceful meanings, feeling of hope and such), but religion demands the fulfillment
of obligations to God or spiritual being. Spirituality is a more general term that includes religion
but that also encompasses the general human impulse to reach out towards the greater whole of
which we all are a part (Kaiser Family Foundation. 2003). The difference between religion and
spirituality is simply that most religions offer a specific set of beliefs and structures to help
people find their innate spirituality.
Spirituality’s influences our political ideology (our obligation to society) and our outlook
on health. It only does not affect our views on health and wellness but also our views on political
advocacy with respect to healthcare reforms. In the State of American Political Ideology (2009),
a study of political values and beliefs, the ideological perspective of the Obama health reform
was reviewed. It revealed that the President has a 58% approval rating and that the country is
progressive more than liberal and that religious coalitions are showing strength in lobbying
toward health care issues, launching media campaigns and political rallying in congress. They
appeal to the masses in internet ads, television and prayer vigils on healthcare topics.
Political decision based on religious reasoning are not wholly beneficial to society as a
whole, including all those who do not share the same religion, but a decision based on secular
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reasoning can be said to be beneficial to most people on a larger platform than that based on a
singular religious belief. As a result, it is alright for religious influence to influence the political
decisions of voters; however a political leader cannot make political decisions out of religious
influence. It is crucial that he uses secular reasoning over religious reasoning and hence secular
and religious influence can influence political decisions, just in asymmetrical proportion.
Spirituality affects our decisions in choosing our political leaders as well as supporting
political policy. Our value systems along with our spiritual beliefs influence what is important to
our daily lives. We want to choose politicians that share our innate beliefs and make policy
decisions reflect our values and whose decisions in politics are in alignment with ours. My
spirituality is reflected in my decisions with morality being the biggest challenge for me.
Factors affecting perspective on health care policy.
My family upbringing has built a foundation on seeing things from all prospective.
Being multi-cultural, I have seen the best and the worst of both worlds. I have seen and
experienced how my country has benefited from the foreign assistance monetarily (tax breaks
and resources) and security (military help) assistance from the United States. It has allowed me
an opportunity to immigrate to a land of opportunity, if I so desire to take it. Yet the struggle for
independence is sometimes tainted by loyalty. Thus, decisions are made to compromise my
homelands benefits to keep alliances with more powerful countries intact. Like everything else
in life, negotiations need to happen and priorities need to be identified for what benefits the most.
My strong spiritual and religious beliefs are intact but I also know that the universe or our
nation is constantly changing. Change is not always bad and can be invigorating to those it
affects: be it financial, emotional or physical. As human beings and as professionals, we have to
evolve with the times. Though issues such as abortions were not even mentioned in the
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conservative world I have lived in, it now has opened doors for conversation and consideration
and understanding of another person’s predicament such as in rape.
In view of healthcare, I feel my professional experience has a strong influence in my
changing direction and my desire to be overly involved. I think of passiveness as a paralyzing
negative factor. Heightened awareness in many aspects of politics helps me stay abreast of the
changes in a profession I have a passion for. I believe that we can only change what we know
and control.
Inconsistencies
The issue I have is in the Obama Administration mandating taxation as a solution to
everything. I feel internal analysis and internal efficiency assessment and intervention should be
primary. The imposition of some aspect of the policy such as mandate of religious employers,
schools and hospital including charities is a violation of first amendment rights and liberty of
establishment you render free care for the public in deep need for the free assistance.
The consequences of ill health are devastating for many families across the world,
throwing many families in a medical-poverty trap (Center for American Progress, 2009). The
reason for universal health care insurance is to make it affordable for all. At the same time,
access to affordable, quality care is essential for all.
The financial solutions should be considered from a redistributive justice perspective
(Center for American Progress, 2009). Health as human right transforms to possible solutions.
Redistributive justice ought to apply to other contentious issues such as debt cancellation and
such. The drive is to render holistic health yet compromises in rendering the ideal care has been
compromised by the many variations in the issues from many prospective. The discourse
requires the integration of one’s value ideology and policy making. A challenge when every
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person has a different meaning to different people. We find ourselves asking: How will we treat
people? Whose responsibility is health care? How will we finance health? (Center for American
Progress, 2009). Getting started in the right direction is the hardest first step, but this author
believes compromises in values and principle may be necessary.
Conclusion
Health as human right is not argued by many but the approach to respect that right could
not be more different. Our nation is in the midst of a healthcare crisis even with advancement of
technology, wealth and financial challenges. Cry for ill politics are thrown here and there. The
insistence of health for all requires creative thinking and policy making. It forces the
government to have a political approach which can infringe on the autonomy and human right.
Health care is a crucial agenda requiring mobilization by many to make a difference in for the
future. Personal values affect our advocacy for our legislation and our causes and as
professionals we should have our voices heard.
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References
Browne, A. J. (2001). The influence of liberal political ideology on nursing science. Nursing
Inquiry. 8(2). 118-129. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11882210
Center for American Progress. (2009). State of American political ideology, 2009: A national
study of values and beliefs. Retrieved from
http://www.americanprogress.org/issues/2009/03/political_ideology.html
Centers for Medicare & Medicaid Services. (2012). Keeping America Healthy. Medicaid.gov.
Retrieved from http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.htm
Federal for Immigration Reform (FAIR). (2011, December). Immigration Issues: Facts.
Retrieved from http://www.fairus.org/issue/how-many-illegal-immigrants
Kaiser Family Foundation. (2003, August). The Kaiser Commission on Medicaid and the
uninsured. Retrieved from http://www.kff.org/uninsured/upload/Immigrants-Health-CareCoverage-and-Access-fact-sheet.pdf
Kaiser Family Foundation. (2009, December). Focus on health Reform: Immigrants health
Coverage and health Reform. Kaiser Commission Report. Retrieved from
http://www.kff.org/healthreform/upload/7982.pdf
Risse, M. (2008). On the Morality of Immigration. Ethics & International Affairs: Carnegie
Council. 22(1). Retrieved
http://www.carnegiecouncil.org/resources/ethics_online/index.html
United States Department of Health & Human Services. (2012, May). Take health care into
your own hands. Retrieved from http://www.healthcare.gov/law/timeline/index.html