Governance Structures and Internal Regulation

Posted: April 4th, 2019

Discussion – Health law and ethics.
Oodule 03: Governance Structures and Internal Regulation
Module 03: Discussion AG
In this scenario, you are the CEO of a healthcare organization. You are preparing for a presentation to community members about how healthcare is geographically located and the ethical effects to insurance versus no-charge healthcare systems.
• What are the differences between insurance and a no-charge healthcare system? What happens to the healthcare organization giving out too much free care? • How do you convince the community that private healthcare insurance is necessary?
Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saud Electronic University academic writing standards and APA style guidelines.

Governance Structures and Internal Regulation
There are key differences between insurance-based and no-charge healthcare systems that impact both patients and healthcare organizations. An insurance-based system sees patients pay monthly premiums to insurance companies, who then reimburse healthcare providers for services rendered (Kliff, 2020). This model incentivizes cost control, as insurers aim to keep premiums low while still covering patients’ needs. However, it also means some patients lack coverage and face financial barriers to care.
A no-charge system eliminates such financial barriers by providing universal healthcare access regardless of ability to pay (Oberlander, 2020). However, without insurance reimbursements, healthcare organizations must rely on other funding sources like government subsidies or charitable donations to cover operational costs (Grogan, 2017). If costs rise above available funding, an organization risks accruing debt that threatens long-term sustainability (Tuohy, 2018). As the CEO of such an organization, balancing service provision with fiscal responsibility would be paramount.
When presenting to the community, emphasizing both ethical and practical considerations could help convince them of private insurance’s role. From an ethical standpoint, lack of coverage leaves some unable to access necessary care (Oberlander, 2020). However, a solely tax-funded model risks over-utilization that could overwhelm limited public resources, reducing quality of care overall (Grogan, 2017; Tuohy, 2018). Private insurance allows for shared responsibility between individuals, employers, and the government to expand access while controlling costs (Kliff, 2020). With proper regulation and subsidies for low-income groups, it can achieve near-universal coverage.
In summary, both models present tradeoffs between access, costs, and organizational sustainability. A balanced approach incorporating private insurance, government aid, and cost controls may optimize health outcomes at the community level. Community support depends on understanding these complex issues from multiple ethical and practical perspectives.
Kliff, S. (2020). The problem with single-payer health care, in one chart. Vox. https://www.vox.com/health-care/2020/1/14/21065353/single-payer-private-insurance-medicare-for-all
Oberlander, J. (2020). The future of single-payer health care in the United States. New England Journal of Medicine, 383(13), 1201-1204. https://doi.org/10.1056/NEJMp2017755 research essay writing service.

Grogan, C. M. (2017). The political-economic factors driving state decisions on the Medicaid expansion. Journal of Health Politics, Policy and Law, 42(4), 589-618. https://doi.org/10.1215/03616878-3848495
Tuohy, C. H. (2018). Health care restructuring in Canada: What’s wrong with the standard model? Journal of Health Politics, Policy and Law, 43(5), 771-792. https://doi.org/10.1215/03616878-6991520