Strides in Healthcare Disparities

Chapter 10, 11, and 12 of our book "Beyond Bioethics" discuss the factors in healthcare disparities aided by our fundamental ethical approaches. I decided to further investigate ways we can aid these disparities and minimize the gap year by year. First, we look at an issue that the author, Derek Ayeh, discusses in chapter 11: the interest in future technology and the forward-looking bioethicist that often overlook the ethical issues present in healthcare today:

This complexity of this issue comes from nature of disparities that arise in health v healthcare. When you discuss inequities in health you refer to the groups of people that are affected by a higher chance of illnesses in comparison to another groups. While health care disparities are focused on a group(s) that face a different standard of healthcare, i.e., access and use of healthcare. Both are affected by environmental and societal factors explaining the difficulty in trying to find a solution solely through the field. One aspect discussed in chapter 12 was the progression of bioethicist being driven by the financial legitimacy that can be established via bureaucratic procedures. The fundamental that have yet to be addressed, I feel, as a partner of bioethics, is business ethics.

So, what is business ethics and why is it important to bioethics? Business ethics, according to the Marrkula Center at the University of Santa Clara, carries three different “strands”. First it looks at the standard of academic writing, research and publications, this term entered the US in the 1970’s during the development of academia. The second refers to its media usage regarding “business scandals” lacking accordance with ethics of business. Finally, the third is the broadest referring to the commercial exchange and economics. The latter studies the history of ethical commercial exchange written by many philosophers like Aristotle in his Politics, John Locke’s understanding of property etc. Business ethics in academia arose because of the need to understand social concerns and how to address these issues. However, it focuses more on how to create an explicit “framework to evaluate business and especially corporate activities” rather than a “social responsibility approach”. This kind of ethics follows a similar path as that of medical ethics.

I would like to focus on the movements spurred business ethics mostly. Legislation created has mostly prompted business ethical standards, such as Civil Rights Act of 1964 and US Occupational Safety and Health Act of 1970. One important piece of legislation that has aided the corporate ethical standard is the Foreign Corrupt Practices Act, that prohibited US corporations from paying government official for special considerations, although this was already an ethical norm that was followed by many, the implementation of this ethical standard was needed.

Business ethics is important to discuss when you examine the pharmaceutical companies that profit off of health care. Take a look at the company Mylan that sells EpiPens, a cost of this lifesaving epinephrine dosage can cost around 500 or more depending on your insurance plan, deductible, etc. This cost is for 2 of these dosages (note, it’s always recommended to carry 2 of these dosages on you due to possibility of the ineffectiveness of the first one). In 2015 Mylan’s profits hit 1.2 billion and the EpiPens make up 40% of those profits. While Mylan claims that they have always strived to make their EpiPen accessible, legislatures have questioned their ethical approach to the prices of these lifesaving drugs. In fact, according to a NYTimes article, seven pharmaceutical executives are going to testify today, Tuesday 26, 2019, before the Senate Finance Committee to discuss the prices of pharmaceutical drugs. Some believe this is going to be a turning point in the big pharma culture. I believe if we continue to make strides and campaigns to disrupt the unethical standards common in healthcare, we can close these disparities.

Articles to consider (my works cited)

https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/

https://www.scu.edu/ethics/focus-areas/business-ethics/resources/a-history-of-business-ethics/

https://www.nytimes.com/2019/02/24/opinion/drug-prices-congress.html

https://www.forbes.com/sites/emilywillingham/2016/08/21/why-did-mylan-hike-epipen-prices-400-because-they-could/#5d7d609c280c