Free «Obamacare/Trumpcare» Essay


The health sector in the United States represents a vital area, which is at times marred by serious ethical concerns. Conflicts here are common, and nurses have evolved means of dealing with them. Nonetheless, ethical concerns necessitate a broad inquiry into solutions. Since 2010, Americans have been involved in a heated national debate over the Patient Protection and Affordable Care Act (ACA). It is commonly referred to as Obamacare. Notwithstanding Obama’s glowing account of his achievement, research on the previous six-year records have unearthed that there exist serious ethical concerns regarding the ACA (Pratt, 2013). Various conflicts between ethics and the healthcare reform that has been established include firing workers, rising costs of insurance leading to the burdening of families and businesses, forcing Americans to fund abortion through their tax dollars, and imposing arbitrary regulations and expensive mandates on others. The Act has made access to quality care challenging because of the growing number of the uninsured, but nurses have been able to negotiate conflicts through mediation and effective communication.

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Ethics and the Healthcare Reform: Conflicts

Firing Employees

The ACA has impacted choices of various corporations across the United States, where accountants in firms are regularly concerned about reducing costs to maximize returns. It has been observed that firing full-time workers and engaging part-time replacements may aid to decrease expenditures, but the executive’s choice affects both the firm and employees together with their families and the nation’s general economic health. It is undebatable that times have been challenging in the recent past. With the persistent financial degeneration, occupations have been extremely challenging to get, and several persons have remained incapable of affording fundamental things notwithstanding health indemnification (Fronstin, 2013). Obama observed the challenges individuals faced in accessing affordable health insurance and spearheaded the creation of the ACA. With the Act, employers and many businesses were compelled to offer health coverage to nearly 95% of their full-time workers and dependents ranging to the age of twenty-six. It resulted in a serious ethical conflict because it made employers and many businesses reassess their full-time workers status (Fronstin, 2014; Tanner, 2013). As a result, most corporations opt to fire employees and replace them with part-time ones, with whom they are not obliged to pay for their health coverage. Firing workers with the downturned economy offers a very enticing prospect for employers seeking to reduce costs wherever possible. It has serious ramifications for other people, particularly dependents of full-time employees who have been fired. It is because such dependents also profit from health cover. Several surveys reveal that numerous Americans characteristically pay more for healthcare and corporations reduce their workforce. It may adversely impact the economy instead of enhancing it like the ACA has initially envisioned.

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ACA and Abortion

Another conflict that arises between ethics and the ACA is the assertion that the latter compels Americans to finance abortion through their duty dollars, which is direct desecration of their rights of conscience. During his term, President Obama stated that there were no plans whatsoever under health reform to revoke the prevailing prohibition on using state taxpayer dollars for abortions (Tanner, 2013). Interestingly, creating a sharp discrepancy with the past regulation, the ACA has been observed to sanction the state financing of abortion in its qualified health plans. The breach of ethics is a common occurrence that impacts individuals unevenly. One instance that expounds on the nature of the ethical conflict with the healthcare reform represents the situation when Kathleen Sebelius, the Health and Human Services Secretary, mandated employers and workers to fund state-certified abortion-inducing medications among various things (Tanner, 2013). Though the unprecedented order was partially overturned by the United States Supreme Court, it has been observed as still being functional for various employers and a subject of continuing federal litigation.

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Arbitrary Rules and Expensive Mandates

The fact that the ACA imposes costly mandates and arbitrary rules ignites a conflict between ethics and the healthcare reform. It has been perceived that there exists a trend where federal representatives create and enforce the increased body of rules in the American healthcare sector. Federal bodies are accountable for the issuance of ACA regulations. Nonetheless, the ACA forms many other programs and panels whose exact number remains unknown since most of them may be created administratively (Pearlman, 2013). Additionally, the lucidity of ACA regulations is uneven making their application dependent on interpretation and implementation by federal regulators who have been blamed for being unethical in this process. Similarly, ACA’s transfer of broad discretionary powers to federal agencies and departments permits federal officials to issue regulations and make exceptions to them, as well as to offer waivers or enact them for diverse population segments disproportionately. It is unethical, contributing to the conflict between ethics and the healthcare reform.

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Negotiating Conflicts

Interdisciplinary conflicts have become more public with the implementation of the ACA. Resolving wrangles between ethics and the health reform is vital for the employer and workers to be able to reap the benefits. Nurses play important roles in addressing such conflicts. Through mediation that comprises value-based and identity-based issues, they can resolve the dispute. Historically, nurses have focused on the identity and values more than on policies and budgetary problems (Pearlman, 2013). It has been observed that in the nursing profession and particularly in conflicts relating to the ACA, trust, values, and expert recognition connected with offering ideal care to all are essential aspects, with which nurses identify their work and handled conflicts of interest. In mediating the latter, it becomes imperative for nurses to acknowledge that eventually some individuals may lack access to ideal care and need to depend on a safety net of emergency rooms and Medicaid. It is a long-held belief that when nurses remain in control and lead healthcare delivery without necessarily having to negotiate their role with others, it is conceivable that the system may transform.

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Most of the conflicts stated earlier are highly facilitated by the lack of communication, which results in an interpersonal dispute between care providers, employers, and employees among other persons involved (Shay & Mick, 2013). Nonetheless, such negative situations require being resolved and managed efficiently. As such, nurses can enhance communication between providers and patients and partake in conflict resolution programs. As healthcare experts, they must spearhead the amicable resolution of ethical challenges.

Uninsured Population

Although there are a substantial number of insured individuals, nonetheless the research has established that the majority of Americans are still uninsured (Fronstin, 2014). Most of these have been observed to be disproportionately poor, Hispanics and Blacks. A considerable figure of the uninsured is children. The gaps in the ACA have denied benefits to millions of individuals the Act was intended to assist. Nonetheless, a trend has been observed where most of the non-insured are people who are capable of obtaining coverage under the law. Though many of the Americans are eligible for coverage, most never sign up. As a result, such individuals are banned from obtaining Medicaid or procuring cover. Additionally, they are not afforded the best care conceivable.

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The ACA was envisioned to offer quality and affordable care to all Americans. However, this has not been largely the case since there are numerous reservations regarding the healthcare reform. Most essentially have been conflicts observed between ethics and the ACA, which range from firing workers, burdening employees and families by raising cover costs, compelling Americans to fund abortion through their duties, and imposing arbitrary regulations. These struggles have had a momentous effect on care provision. Nonetheless, nurses have evolved some ways of dealing with the conflicts, among them being enhancing communication, leading by example, and mediation. However, since the number of uninsured Americans continues to grow, it has resulted in a lot of people being deprived of Medicaid and ideal care.

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