Ethical Dilemma in Health Care System in United States of America: ‘Old versus Youth’

Health care is available to those who have lived a full natural life span; The young people versus the older people in terms of health care issue, it will guide to denying care to people of younger people and other groups consider less productive to society.

Economic Issue:

By the year 2040 the elderly will represent 21 per cent of the population. Older people are more likely to need health care than the young. In 1980 people over 65 accounted for 29 per cent of the total American health care expenditures of $219.4 billion. By the 1996 the bill has risen to $450 billion and the share devoted to the elderly to 31 per cent. The cost of Medicare is projected to increase from $75 billion in 1986 to $114 billion in the year 2000. If the health care service limit health care to older people the cost will increase and if the health policy re-examined by the health care service we can save large amount of money.

Beneficence:

Every one wants to live longer and taken care of both older and younger. What we want for medicine to do for us as we agree.

Autonomy:

Government's responsibilities to the people whether both the young and the older people should be benefited for the health services.

Justice:

We need a notion of a full life that is based on some deeper understanding of human needs and possibilities, not in the state of medical technology or its potential.

Do No Harm:

Young people should have a health care policy, neither should we avoid the older generations.

Social:

The burdens of health care costs are increasing rapidly for the elderly people. The reason for failing is providing decent long-term care and the system of medicare needs to be reformed because it constitutes a heavy out of pocket drain. Women who are widowed or single or minority are disadvantaged. It has been noticed that a large share of health care benefit is going to the elderly people rather than to young people. United States spends about 1 per cent of the GNP on health care for dying elderly person. Harvard University mentioned that many of the practice such as kidney dialysis were developed for young people but in reality some 30 per cent of its recipients are older people. The young people are taking the bear of the cost of the old people, and when the young people will become old, is there any guarantee that they will get the same care and moreover whether there is any possibilities that any cutback in health care for the elderly people would result in a transfer of the savings to the young people. A studies shows that it is very difficult to measure some one is dying; the most expensive patients, it turn out, are those who are expected to live but died. A longer life does not guarantee a better life. No matter how long medicine enables people to live, death at any time (90-100 years). Would frustrate some possibility, some as yet unrealised goal. Death for a young people is a tragedy but death at the older age, after a full life is part of natural life. Spending money to extend an older people life is just like a 'bottom less spending'.

Options:

The following way the health care provider can serve both the society's need for cost containment and being patient advocate:

Government should help people live out a normal lifespan, not help people live beyond a normal lifespan. Government should develop life-extending technology only to the degree that it allows all people to live a natural life span. Beyond the point of natural life span, government should provide the means necessary for the relief of suffering, not for the extension of life. Society will not benefit from allowing expenditures on supporting the elderly to continue to increase; nor will it benefit from persisting the argument that young people will eventually benefit from such expenditure. If healthcare for elderly people is limited, it will create a disparity between the rich and the poor, as rich people will continue to buy the entire healthcare they need, and poor people will be forced to live without.

Recommendations:

Government could stop all interventions for which there is no hard evidence that they are beneficial. Government should set lower profit margins for such situations as the non-doctor owners of dialysis units and nursing homes. The standard of what is "old" should be re-evaluated.

There is evidence that people who continue to have meaningful work will live longer and healthier lives. Allowing elderly people to retain Social Security benefits while working would immediately raise significant tax revenues.n

Submitted By
Shakeel Ahmed Ibne Mahmood
The author is a Senior Administrative Officer, ICDDR,B, Currently enrolled in MPA programme at University of Maine, USA.

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