CASE 6: Jumping the Queue with Private HealthCare Lynette Re
CASE 6: Jumping the Queue with Private HealthCare Lynette Reid… CASE 6: Jumping the Queue with Private HealthCareLynette Reid (2017) comments that “equity in access to health care is achieved when access is based on medical need and not on factors irrelevant to medical need, such as ability to pay (p. 155). She argues that the provision of needed care on an ‘ability-to-pay’ basis is not just a violation of health equity, it is contrary to health equity” (p. 155).Reid distinguishes three models of health care delivery in Canada that require payment of fees as a condition of accessing care: 1) the “concierge medicine” model, in which typically a physician “charges an annual fee to members of the practice … and offers a level of personal attention that is impossible when care is funded by common (public or private) payers,” and which may include such extras as annual wellness check-ups, and around-the-clock access without wait times; 2) the “wellness practice” or “boutique” model, in which physicians pool with other health professionals who deliver related care; and 3) the “block fee” or “private clinic” model, in which physicians provide additional services not otherwise covered, such as third-party examinations and wart removal, by paying a “block fee” (p. 152). The case below concerns ability to pay as a conduit (and barrier) to accelerated access to consultation with a surgeon at a private clinic. By paying a fee, the patient could get an appointment much sooner than he could with the same surgeon at the publicly-funded hospital.320Concepts and Cases in Nursing EthicsHassan works part-time as a registered nurse on a surgical unit. Due to a back injury, he is unable to work. He has no benefits and is eager to return to work as soon as possible. His family physician recommends back surgery and refers him to Dr. Stone, a surgeon Hassan has worked with on the surgical unit.After three months, Hassan had not heard from the surgeon’s office. He called to ask when he would have his consultation and was told by the sur- geon’s nurse he would have to wait another six months but could have it much sooner if he went to a private clinic. The cost of the consultation would be about $4000. Hassan borrowed the money from his parents, received the contact information, and made an appointment for the following week.When he arrived for his private consultation, he was surprised at being seen by Dr. Stone, who he learned was a partner with other local surgeons in the clinic. Within two weeks, he received a date for his operation at the local hospital. The surgery and hospital costs were covered by the provincial health care plan. In three months he was able to return to work. However, as a strong supporter of medicare he felt uneasy knowing that by paying for a private consultation he was able to jump the queue ahead of patients who were not able to pay. : If you were in Hassan’s shoes, would you continue to go to a private clinic and pay $4000 for a faster operation process, knowing that you would be skipping other patients who couldn’t afford it to jump in queue? Use an ethical principle to explain.Health Science Science Nursing NURS 403
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