Medical Care and Ethics

Problems with medical ethics emerge for a great number of reasons

Having the force over the death and life, medical workers can either abuse this power or be negligent with it. Medical ethics joins general ethical principles with medical research. Costing a lot, healthcare arise health-care ethics problems. There appears the question about the payment. Healthcare is a constitutional human right. It means that every ill person should have corresponding access to all forms of cure even if they cannot pay. The first aim of the paper is to show ethical and unethical attitude in the USA and Britain based on the Michael Moore’s documentary movie Sicko. Second, the paper compares and contrasts the U.S. government’s overall tax expenditure with tax expenditure in Britain.

Sicko is an American documentary movie by film director Michael Moore. The film casts light on the American health care system, namely on the pharmaceutical industry and its medical insurance. There is a parallel in this documentary between the commercial system of the United States and the non-profit-making universal medical systems of the United Kingdom, France, Canada, and Cuba.

As stated in this film, nearly fifty million Americans do not have insurance at all, while the other citizens, who have it, often face deception and bureaucracy from the insurance companies. Moreover, Michael Moore highlights that the health care system of the United States is on the 37th position by the death rate of children under the age of one year, what is nearly the same comparing with less economically developed countries.

People involved in this film have had corresponding coverage, but their insurance companies have refused to provide them with medical care. Embarrassingly, former medical workers of insurance companies report about the reduction of costs initiatives. Due to such initiatives, doctors from insurance companies earn good bonuses. More than that, finding motives to elude the necessity of treatment enlarges profit received by the company.

According to Becky Malke, the call-center worker in the insurance company, there exist a lot of certain conditions without coverage. Having heart disease, diabetes, cancer etc.  lessens the possibility to get medical insurance. More than that, the list of these conditions is extremely large. Having a mass index that is too high or too low is also a reason for medical insurance rejection.

Adrian Campbell from Detroit is a single mother, she is 22, and she has a cervical cancer

Surprisingly, she has had a rejection from the insurance company. The reason is that she is too young to have a cervical cancer. Being rejected by the health care system of the United States, she decided to cross the border and become a Canadian with a help of her Canadian friend Kyle. Adrian states that Americans get married to Canadians to have an appropriate healthcare. Being treated like this, Adrian has no possibility to have a medical treatment that she needs. Moreover, the reason for rejection sounds not only unethical, but also like an absurd.  The person should not be rejected in cure only depending on the age or possibility to have or not to have this disease.

Another earth-shattering case deals with Dawnelle Keyes and her 18-month-old daughter, Mychelle. She has Kaiser Permanente insurance. One night, Dawnelle’s daughter had a fever over 104° F. Being alarmed, she called 911. The ambulance took her daughter to the hospital nearby. Having checked her health maintenance organization, it appeared that Kaiser could not cover necessary treatment for her daughter in this hospital. The only way out was to bring Mychelle by car to the Martin Luther King hospital. Dawnelle continued begging doctors to help her child, meanwhile Mychelle got worse and had a seizure. After several hours of delay, they came to Kaiser. Unfortunately, it was too late, Mychelle had cardiac arrest. Having tried to revive her for nearly 30 minutes, the physicians informed the mother about Mychelle death. Dawnelle was shocked and frustrated. Having tried to do her best to save her child, she was not able to help her. This case is regarded to be unethical. For the reason that little innocent baby has died not because of the doctors’ acknowledge, but because of the rules in the health care system.

One more terrible case happened with American heroes, namely the firefighters and police officers, recovery and rescue workers, and volunteers. Being not the city employees but just volunteers, a lot of rescue workers who have worked on the Ground Zero have obtained serious respiratory illnesses. After this tragedy, the government has stated that they have not been in the list of the company's employees. For example, Reggie Cervantes worked as a volunteer. She treated people at Ground Zero for several days. According to Reggie, she had breathing trouble after the first week, but she did not stop searching for alive people. Now she has a terrible cough and problems with breathing. Unfortunately, neither medicine nor water can stop it. At the moment, she is too sick to work, she has left her job and lives without income, and she has moved with children to the country. Having unethical attitude and being ignored by the government and American medical system she has no clue how to get the necessary help. Later, Reggie travelled to Cuba with Michael Moore and other characters from the film and discovered that her medicine costs 3.20 pesos there. It is like 5 cents in the U.S., but Reggie pays 120 dollars for it at home. Moreover, everyone gets free medical care at the Hermanos Ameijeiras Hospital.

Michael Moore highlights that not everybody is ignored by the government after the tragedy on the 11th of September. For example, Abu Zubaydah, Khalid Sheikh Mohammed, Ramzi Binalshibh and 11 other terrorists in CIA are in confinement in Guantanamo Bay. Unbelievable, but these prisoners can use the dental clinic, physiotherapy, a room specially equipped for surgical operations, x-ray, screening for cancer. The doctors test all the terrorists three times per week. This case is regarded to be unethical, because comparing with these prisoners not every heroic person involved in this tragedy has access to appropriate medical care.

Another interviewer is Erik Turnbow from Washington. Having saved enough money, he decides to visit famous Abbey Road crosswalk in London. Choosing a rather extreme way of crossing it (walking on his hands) he has put his shoulder out. Surprisingly for him, he has not paid for his stay and treatment in the British hospital. More than that, the anesthetic cost him only about 10 dollars. Being even the foreigner, Eric has received the entire cure immediately without paying for it. That is why this case is considered to be ethical.

Moore decides to travel to the United Kingdom and to make an investigation about free hospital stay and drugs only for ten dollars.  He has a dialogue with a British pharmacist. After this conversation, he finds out that if a person has a prescription no matter for how many pills, it will cost only 6.65 pounds. That is the standard price, even if a person needs an HIV drug or a cancer drug. The only exception is made for people under 16 or over 60, they get drugs for free. The reason is that only a working adult can earn enough money to pay this sum. The price of the medicine and exception for the age are regarded to be ethical for patients.

After the chemist's shop, Moore visits a state hospital in London. He asks people about hospital charges, but everyone just laughs. The reason is that there is the National Health Service in Great Britain, and it is an entirely publicly funded health care system. Having national insurance, there is no bill at the end of the treatment, everything is free. Besides, there is a "cashier" where the man behind the counter gives money if a patient had to pay for transport. British government gives not only free healthcare but also gives money for the transport. This case is very ethical according to ill people.

Having interviewed one British family doctor, Moore discovers that the government pays for family practice

Before treating patients, there is no need to call the government insurance company. Doctors do not deal with money at all on an everyday basis. There are no cases when patients have been removed from the hospital because they had no money. Moreover, working in the family practice, this doctor has Audi, lives in Greenwich in a lovely three-story house that costs nearly million dollars. More than that, he earns around 85,000 pounds, including pension. The doctor explains that they get paid more if they have helped their patients to stop smoking, or they have low blood pressure, or they have mental health reviews. As a result, all doctors are interested in the ethical attitude towards the patients.

After visiting Canada, France, Great Britain, and even Cuba, Moore has been too surprised with their health care systems and other benefits for citizens.

Looking back in the history of the American health care, there is a great anti-communist propaganda, also against the universal health care. Ronald Reagan urges cautions against universal health care, because it can lead to socialism and lost freedoms. At the same time, Moore highlights that such socialized public services as a fire service, public education, police, community libraries, the United States Postal Service do not give rise to communism in the United States. At the end of the film, Michael Moore sums up that the United States is the only country of the western world without universal healthcare.

A potentially influential way to lessen budget deficits is to reduce tax expenditures. Nevertheless, tax expenditures ensure essential profits to the economy. This compromise makes it significant to indicate the benefits and costs of important tax expenditures to define which of them are the most valuable. “Tax expenditures – the exemption of certain economic activities from taxation – account for over a trillion dollars of annual federal, state, and local government spending” (Chetty et al. 1).

The federal budget of the United States comprises different expenditures, such as military spending, the Medicare and Social Security programs and discretionary funding for Cabinet Departments and agencies. 

The pie chart provides the information about distribution of Discretionary Spending for FY 2013. According to it, the government spends on the Military nearly 57% of the budget, comparing with Health $80.6b (5%), Education $67.7b (6%), The Social Security & Unemployment $11.6b (34%) etc. Moreover, military costs have harshly risen after the beginning of terrorism growth, from $294b in the fiscal year 2000 to $705b in the fiscal year 2013 (US Military Spending). Comparing with military budget spending in the UK, it has spent nearly 57.9b dollars. Having NHS, the United Kingdom has spent £ 106.9b on Health, which is nearly 18% of all spending, £ 52.8b on Education (13%) (Spending Round 2013).

In conclusion, dealing with this information, it is possible to figure out that the U.S. government can trim from some categories to match the percent that England spends on medical care to provide their citizens with free healthcare. The common perception outside the U.S. is that there is more than enough money to do this. Unfortunately, the government has decided to spend an exorbitant amount of tax revenues on the military. The government spends money on maintaining hundreds of U.S. military bases in many countries around the globe and billions of dollars on aid for the foreign militaries, such as Egypt’s.