Legal Aspects of Healthcare Management in the USA

Introduction

Current investigations show that the United States is one of the countries that are ready to spend much money on health care in comparison to other countries in the whole world (Hammaker, 2011). However, the intentions of the government to improve the conditions of health care cannot be defined as successful because there are still a number of problems, challenges, and mistakes that put human lives under threat.

Hammaker (2011) admits that the development and improvement of the US health care system are possible in case the rethinking of old and present ideas occurs because many Americans cannot understand what they actually see and what they can use in terms of health care. Collective thinking and the interpretation of information should be taken into consideration when the analysis of legal health care should be developed.

Understanding of health law includes the necessity to learn the basics of the US Constitution and even the Declaration of Independence. Besides, there are several types of laws like statutory, common, or administrative laws that help to realize the rights and needs of patients and other stakeholders of the health care industry. Finally, the evaluation of legal health care should be based on the analysis of court decisions and their impact on people. A number of cases are based on the discussion of abortion, end of life, genetics, and some administrative issues.

Legal aspects of the US healthcare vary considerably and help to realize that the country continues taking steps and improving the conditions under which health care is offered to people; however, the current concern and problems cannot be neglected because the US healthcare system is not perfect, and the provision of laws, criminal penalties, and legal standards is the decision that the country could make in order to change the situation and help people enjoy health care and avoid medical and administrative malpractice.

Historical Background of Health Care and Law in the United States

Legal aspects of healthcare cannot be understood without the investigation of the historical backgrounds of health care. First hospitals appeared under the rules of two civilizations, the Hindu and the Egyptians (Pozgar & Santucci, 2016). The development of Greek and Roman hospitals was observed between the 5th century and the 15th century AD.

Religion, politics, and military relations influenced the appearance of hospitals around the whole world. Still, only the years at the beginning of the 18th century were defined as the period when appropriate hospitals and healthcare services revived (Pozgar & Santucci, 2016). Manhattan Island, Philadelphia, and New York City were the first allocations of hospitals where the citizens of America could ask for healthcare services.

Though the services were offered to soldiers only at the beginning, the reasons to ask for treatment were identified and improved so that a number of citizens could go to a hospital and request for help. For a long period of time, people considered hospitals as the places where their diseases could be diagnosed and treated. Health care was based on the provision of available services and improvements in the quality of life.

Nowadays, the development of health care promotes a number of changes. It is not enough to believe that a hospital is a place where medical services could be offered. Hospitals are the places where new medicine and treatments are offered as well as many legal, financial, and human resource issues have to be taken into consideration (Pozgar & Santucci, 2016).

It is not always possible for people to get medical help in case they are not aware of certain legal issues. Therefore, some researchers admit that law and medicine are the fields that have a number of similarities because both are “practiced” and defined as inexact sciences where interpretations and changes occur and questions are never precisely addressed (Steiner, 2013). The first cases of health care law were observed during the colonial period when English law was applied in the majority of colonies in regard to the needs of new land.

However, with time, the situation was changed. The results of the American Revolution proved that people could improve existing laws and consider their own needs and expectations. For example, in 1829, the decision of the US Supreme Court included the possibility to consider the common law of England not an obligation for the Americans but the basis the parts of which could be “applicable to their situations” (Pozgar & Santucci, 2016, p. 18). As a result of such court decisions, different states of America got the right to adopt the laws on their own and consider some aspects of the existing English, Spanish, and French laws.

As soon as laws and standards were identified, people got a chance to solve their ethical dilemmas, concerns, and misunderstandings with the help of constitutions, statutes, regulations, and case laws. To succeed in using laws in healthcare management, people have to realize that “laws are the very bulwarks of liberty; they define every man’s rights, and defend the individual liberties of all men” (Pozgar & Santucci, 2016, p. 16).

Importance of Legal Principles in Health Care

A number of legal and ethical issues are usually discussed in terms of health care. On the one hand, a law is a possibility to establish social rules and standards the violation of which could impose the creation of some kind of criminal liability and civil responsibility. On the other hand, a law has to be properly managed to understand and avoid risks and consider the needs and expectations of citizens. In other words, some new challenges and liabilities could appear during the period when it is necessary to create the solutions to the already existing challenges and concerns.

In the United States, there are two forms in which law could be created. There are federal and state laws. People could use the norms of the administrative system, the civil system, and the criminal system. For example, the criminal justice system is defined as an opportunity to decrease the existing health disparities and provide all people with a chance to ask for health care and get the required portion of treatment (Binswanger, Redmond, Steiner, & Hicks, 2011). Ordinary people are under a threat of facing medical maltreatment and the inabilities to protect their rights and prove the mistakes. Therefore, they have to rely on a list of legal and ethical principles according to which healthcare workers cannot avoid their responsibilities and responses.

At the same time, employees have to be protected by the rules and obligations imposed by their companies. It could happen that the leaders of companies reject the provision of healthcare services or insurance due to some personal beliefs and ideals. The example is the case Gilardi v. US Department of Health and Human Services in 2013.

The essence of that case was the impossibility to combine the religious preferences of the company’s leaders with the human rights. The Gilardi brothers, as the adherents of the Catholic Church, did neither believe in nor support the ideas of contraception, sterilization, and abortion. Therefore, they did not agree to provide their employees with health insurance that could cover such issues (Gilardi v. United States department of health and human services, 2013). In result, the government did not have compelling interests with the help of which the plaintiff’s position could be supported so that the imposition on the Gilardis was justified (Wheaton, 2013).

The chosen court decision and the presence of similar cases prove that people cannot find the required balance between healthcare and legal aspects. It is necessary to analyze each situation separately and clarify if there are enough reasons to support or reject the idea. Healthcare is the field where mistakes and misunderstandings occur very often, and people are in need of some clarifications and support.

The development of legal principles, law, and regulations is the chance to provide people with hope and clarity that their health and treatment are safe and directed to improve the quality of a human life. Justice in health care could be achieved in case the government starts paying its attention to the improvement of the legal system of the country.

Basic Law Concepts in the US Health Care

Laws in health care have been developed during the last several centuries. The result of such development is the creation of a strong health care system with different types of laws and impacts on citizens. The aim of laws is to govern the relations between various private individuals, public organizations, and the government.

Taking into consideration the nature of the relations between people, the law could be divided into public law (the cases that discuss the relations between people and the government) and private law (the cases that discuss the relationships between individuals) (Pozgar & Santucci, 2016). Public law helps to clarify the conditions when the steps taken by individuals or organizations do harm to patients or lead to injuries. Private law is a kind of opposition to public law because it includes the cases when human rights are discussed.

Americans underline that their healthcare system is far from being perfect. In addition to the fact that not all people could allow themselves getting appropriate, timely treatment, people cannot be confident in the quality of the offered services. The investigations developed by British researchers prove the disadvantages of the system and explain that a number of British people, who have to work in the United States, agree to pay for their flights and return home in order to get the required portion of medical help. British people admit that it remains to be cheaper to go home and get treatment in comparison to the prices established by the American government (McSherry, 2015).

There are no laws or regulations that could protect people against spending their money. If British people, who live in the United States for some reason, have a chance to go home and be treated, the Americans are at a loss because there are no legal and appropriate ways to take care of their health and use the free help of medical experts in time. The case Whole Woman’s Health v. Cole is the example of how people have to deal with the questions of poverty when the necessity to solve health issues arises. The decision of the court proved that Texas women had a constitutional right to safe and legal abortion care regardless their economic and social positions (Whole woman’s health v. Cole, 2013).

Regarding the possibilities of the law to stabilize human lives and provide the answers and explanations, it is wrong to avoid its effects. Human behavior is guided by law in medicine as well as in other daily life activities. Though a number of cases and situation are discussed and resolved without the help of lawyers and courts, the existence of the legal system is the stimulus for people to solve their questions in a short period of time and to avoid misunderstandings that have to be solved on public (Steiner, 2013). Legal principles help to reinforce the already developed settlements and statements and create the advantages for people, who want to address the legal system of the country.

Legislation in Health Care

Today, in the United States, there are several important acts, codes, rules, and regulations that define the possibilities of Americans and protect the rights of people. The most important laws and acts appeared in the middle of the 1990s century. Though the Equal Pay Act of 1963 had nothing in common with health care and medical services, it promoted the creation of equal working conditions for men and women and promoted the development of equality among employees (Steiner, 2013).

Such act helped to create a basis for people to rely on while developing other aspects of human services and care. In one year, the Civil Rights Act was introduced in order to prohibit the cases of discrimination of Americans in regards to their gender, race, color, origins, etc. People got a chance for equal services and opportunities and used their chances to ask for help and care.

1970 was the year when the Occupational Safety and Health Act was developed (Steiner, 2013). According to the act, all states had to consider legislation with the help of which the implementation of standards for various industries could identify safety norms. It was one of the first legislations where people understand the worth of their health and safety even if they have to work and take responsibilities.

In other words, employers had to take care of their worker and create the conditions under which no harm to health could be observed. The Rehabilitation Act of 1973 played an important role in the health care of the United States because it identified the conditions under which people with disabilities would have job opportunities and benefits to such organizations as mental health centers or nursing homes.

With time, the development of regulations and laws became a significant point for consideration because the government tried to create the conditions that made people (employers) responsible for and aware of the needs of other people (employees). There is the Pregnancy Discrimination Act (1978) under which all pregnant women with appropriate medical conditions could ask for medical care and support of their employers.

In other words, a pregnant woman has a right to a sick leave without being fired. Unfortunately, a number of women tried to use this act as the excuses for their mistakes in the workplace or the inabilities to complete some portion of work. For example, the court decisions of the cases Harris v. City of Santa Monica or Hamilton v. Southland Christian School showed that pregnancy should not be used as the main excuse and defined as the main reasons for the firing. Companies could have other complaints and explanations for such decisions. The Supreme Court supported defendants. The case of Hitchcock v. Angel Corps, where the decision was made in favor of the plaintiff, proved that some companies continued firing women because of their specific conditions.

One of the latest and most remarkable legal achievements in the United States was the introduction of the Patient Protection and Affordable Care Act in March 2010. Also known as Obamacare, the ACA aims at protecting patients’ rights and providing affordable health insurance for all Americans regardless their incomes, age, gender, color, etc.

Though a number of people admired the possibilities to get health insurance with no time limitations and low drug costs, there are a number of disadvantages that frustrate people. For example, a number of people still have to pay some kind of premiums in order to increase their chance to get insurance in a short period of time. Besides, there are certain penalties for people who do not have insurance. Finally, new taxes occur in order to create the conditions for the ACA. People stay confused with the conditions under which they could actually get their health care, treatment, and required medical help.

Protection of Patients’ and Employees’ Rights in the Healthcare Sphere

Taking into consideration the regulations and act the Americans have to rely on when they ask for medical help, it is hard to guess if the legal system improves or destroys the healthcare system of the United States. On the one hand, the ACA helps to establish the main legal protections for people and create the conditions that have been absent for a long period of time (Rosenbaum, 2011). People got a guarantee for affordable health care insurance coverage and the possibility to ask for medical services from birth to retirement. People could stop bothering of their insurances with the help of such act. The number of uninsured people could be reduced considerably. Finally, Medicaid enrollment could be increased by 15 million beneficiaries (Rosenbaum, 2011).

In addition to the possibility to protect people’s rights to health insurance, the ACA proves the importance of such issues as fairness and quality among the Americans. There are no other ways to explain that all people, who are defined as legal American citizens, should have the same opportunities and use the same health insurance coverage.

At the same time, this act helps to increase the quality and values in the healthcare system. Medical workers have to deal with a diverse patient population (Rosenbaum, 2011). Therefore, the healthcare system has to be constantly improved and developed. Finally, the ACA underlines the importance of investments and involvement of a number of people in the discussions of the questions of the public health. However, it is hard for people to understand a true nature of such investments so that they are confused because of the importance of new taxes and penalties.

The rights of employees are not clearly defined in the ACA. Still, medical workers could understand their responsibilities and obligations in regards to the expectations of the government and patients. Some medical workers believe that the idea of strikes as the possibility to solve their problems, increase salaries, or improve working conditions is the only decision they could make.

However, it is necessary to underline that the US federal law prohibits the idea of striking among the employees in the spheres of the government, railroad, airline, firefighting, and even police. Health care is one of few spheres where strikes and picketing are allowed in all states (Pozgar & Santucci, 2016). In health sphere, employees could use any possible means to protect their rights and underline the cases of injustice if any.

Importance of Court Decisions in Health Care

For a long period of time, many people believed that the decisions made by politicians and their own independent decisions could impact their lives. At the same time, they want to believe that there are a number of groups of people whose roles and suggestions remain to be crucial because of different reasons. Still, not much attention has been paid to the impact of court decisions made in the health care. One of the significant differences in the United States is the possibility of its people to challenge any kind of law in court. Therefore, the decisions made in courts may have a considerable impact on the constitutional concepts, personal attitudes to health care and the legal system of the country.

At the same time, court decisions become the examples for ordinary people and the explanations of why some steps should be prevented, and some steps have to be taken in the shortest possible period of time. The examples of court decisions introduced in this project help to realize that courts do not try to support one group of people and convict another group of people. The main task of courts is to clarify all conditions under which a concern occurs and offer the most appropriate solution regarding the existing laws, acts, and regulations.

Conclusion

In general, the connection between the health care and the legal system of the United States cannot be neglected. People want to believe that they could demand medical services, support, and treatment and rely on the law and acts developed by their country. The health care of the United States is one of the most impressive in the whole world. At the same time, a number of challenges and concern occur when people start using the law to protect and explain their healthcare needs. Courts decisions vary considerably, and people cannot predict the outcomes of their complaints. Each state has its rules and regulations. However, regarding the differences between states and various attitudes to health care, a law remains to be the general rule of human behavior that is enforced by the government.

There are public laws and private laws, administrative, statutory, and common laws, etc. Each law is the possibility to create a standard that meets the requirements of patients, medical employees, and employers. The health care system should not include the questions of appropriate treatment only. The analysis of legal aspects of healthcare management shows that people could address the courts to solve their personal problems that are connected with health and professional issues that have a connection to health problems. Though the health care of the United States is not perfect, numerous attempts and improvements have been already observed, and the decreased number of cases in 2016 is the best evidence to offer.

References

Binswanger, I.A., Redmond, N., Steiner, J.F., & Hicks, L.S. (2011). Health disparities and the criminal justice system: An agenda for further research and action. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 89(1), 98-107.

Gilardi v. United States department of health and human services, No. 13-5069. (2013).

Hammaker, D.K. (2011). Health care management and the law: Principles and applications. Clifton Park, NY: Delmar.

McSherry, M. (2015, January 12). Too many choices, high costs and bureaucracy: British expats grade American healthcare system’a pain in the arse’. The Guardian. 

Pozgar, G.D., & Santucci, N. (2016). Legal aspects of health care administration. Burlington, MA: Hones & Bartlett Learning.

Rosenbaum, S. (2011). The patient protection and affordable care act: Implications for public health policy and practice. Public Health Reports, 126(1), 130-135.

Steiner, J.E. (2013). Problems in health care law. Burlington, MA: Hones & Bartlett Learning.

Wheaton, S. (2013, November 1). Court rules contraception mandate infringes on religious freedom. The New York Times.

Whole woman’s health v. Cole, No. 15-274. (2013).