You are a director within your healthcare system at one of the local healthcare facilities and serve as an ad hoc ethics committee member. Your healthcare system’s ethics committee is a multidisciplinary team composed of physicians, nurses, social workers, administrators, chaplains, and other employees. The primary ethics team members include your Committee Chair, which is your Chief Nursing Officer, your company’s Legal Counsel, a Local Ethics Advisor, and several ad-hoc members. A situation has recently occurred at your facility, the ethics committee has requested your assistance to review the information and will require you to present this information at the next meeting.
Case under study:
HealthT Seeks Healthier Employees
HealthT, a moderate-sized for-profit hospital company, was seeking ways to improve its bottom line. Charlie, its chief operating officer, noted the huge company expense for employee healthcare insurance costs. The amount had risen from about $140 million three years ago to $195 million in the current year. HealthT, like most large companies, was self-insured, which meant its expenditures for healthcare were reported as operating expenses and came directly out of its profits. The huge increase in overall healthcare costs infuriated Charlie, and he immediately called the human resources (HR) department demanding that its director meet with him in two hours to justify the large increase. Glen, the HR director, arrived at Charlie’s office on time, knowing that Charlie was a demanding boss. Glen had the following information to share with Charlie.
Glen was pleased to report that over the past three years, HealthT number of employees increased from 28,000 in 2013 to 35,000 in 2016. Healthcare cost per employee had risen only 12.1 percent, or about 4 percent per year. He also pointed out that, with the new network of physicians and hospitals, the per-employee physician expense had dropped from 2013 to 2016.
Charlie was still upset. He almost yelled at Glen. “Look at the total figures! We are spending almost $200 million on employee healthcare expenses, and the costs of chronic illness care have jumped 47.5 percent in just three years. That’s 18 percent per employee! You have to come up with something to control these runaway costs. You have one week to present your recommendations.”
Glen and his staff brainstormed ways to control chronic illness. Although they recognized that most efforts to control chronic disease were long term, they designed the following changes to their employee insurance plan:
1. Higher deductibles for risky activities: Any employee who required healthcare services as a result of a risky activity—defined as skydiving, scuba diving, motorcycle riding, rock climbing, and other similar activities—would have a hospital deductible of $3,000 instead of the normal $500.
2. Smoking: All smokers would be charged an additional $100 per month for their healthcare insurance.
3. Overweight: All employees with a body mass index (BMI) above 25 but less than 30 would be charged an additional $75 per month for healthcare insurance, and those with a BMI over 30 would be charged an additional $150 per month.
Glen presented the recommendations to Charlie, who thought they were great and asked that they be implemented immediately. Glen thought the changes would be received positively by employees, but he almost instantly began to receive complaints that the changes were not fair.
Ethical Decision-Making Steps:
Presentation to the Ethics Committee
Administrator’s Instructions: Complete this form, the Ethical Decision-Making Steps, based on the ethical case. You will be presenting this information during your next ethics committee meeting. Provide a response to each step below, ensuring that sufficient details are provided with supporting evidence. (Your supporting evidence will need to be presented in APA format using in-text citations and remember to include a separate APA formatted Reference Page that your executive leaders may refer to in order to obtain additional information on your responses. Your references should be from the last five years.
Complete the following ethical decision-making steps below for your case: (Note: Appropriately adjust the spacing below for each step to provide your information and explaination based on the case)
Step One: Recognize the Background (The Circumstances Leading to the Ethics Conflict.)
Step Two: Identify the Specific Ethical Question(s) that Need Clarification.
Step Three: Consider the Related Ethical Principles and/or Organizational Values
Step Four: Determine the Options for Response(s).
Step Five: Recommend a Response(s).
Step Six: Anticipate the Ethical Conflict.
Apply the concept of ethical principles, communication, cultural competency, and health literacy for this assignment while completing ethical decision-making forms