When the public sector in United States enters into a managed care arrangements for the provision of services in the health care for mentally disabled, certain ethical dilemmas will arise.
Some of the roles of the following ethical concern in public sector managed care (PSMC) systems are: confidentiality, informed consent, full disclosure, double-a gentry and conflicts of interest, honesty, financial incentives and disincentives, outcomes, interference in the clinical relationship, relationships among mental health professionals, consumers as providers, telemedicine, formulary restrictions, leverage, inadequate experience of PSMC systems, and organizational issues
In United States, Health disparities can be diminished when barriers to treatment are addressed, mentally retardation face common health care barriers including: Poverty – economic deprivation among those with mentally retarded often precludes access to quality health care, Coordination of Service Problems – people with mentally retardation often deal with a tangled bureaucracy of case managers, social workers, job counselors, therapists, and child welfare workers.
In many cases, conflicting agendas from disparate health care and social services agencies create bottlenecks in health care access. Like many other health care system, patients with mental retardation can’t deal with outside commitments without adequate childcare training. When childcare becomes a problem, those with mental retardation are often punished for missing medical appointments. Multiple Health Needs – are patients often suffer from co existing conditions including depression and substance abuse.
One of the problems of the United States health care system is the performance of the doctors they commonly don’t have the skills to deal with the special situations, and their patients tend to be neglected by the health care system. Mentally retardation patients continuing problems are their social interaction (Tim Shiver: Mentally disabled deserve health care). The United States has primarily focused on alternatives to populations control methods thorough providing adequate health care and education.
They largely endorse the importance of the individual rights and the rights of the disabled. Equality of all individuals regardless of gender and mentally are issues that receive political attention. Americans place a high value on all human life the country’s population assumes responsibility basically for all the children that are born within the country’s boundaries. Changing United States Demographic Structures
A major factor affecting the need and demand for mental health providers and consequently the number of active specialty service providers and trainees is the projected short – term change in the demographic structure of the nation. The anticipated changes in the structure between 2002 and 2005 will have the significant consequences for the need and demand for providers of mental health services. Recent treatment and technological advances in psychiatric practice may influence both the supply and of the demand for the services with the roles they may play in treating the mental patients in the future (Olfson et.Al. 2002)
Over the past decades, the specialty mental health system has undergone substantial changes in the organization, in the delivery of the service and the financing of the care. Other medical specialties, psychiatric services in both the private and public sectors have increasingly shifted from unmanaged fee- for- service reimbursement to virtually all mental health and substance abuse treatment services being subject to some form of fee management (Findlay. 1999). Conclusion United States is one of the richest nations worldwide in terms of advance technology.
But the federal government did not give its full support in the health care agency especially in the mentally disabled health care institutions. In the year 1900s, United States was a commonplace of contract medicines and it was conducted by many kinds of organizations – not only by companies but also by multitudes of fraternal orders and lodges, which began offering subscription medical services to their members and its violated the sacred fiduciary relationship between physicians and their patients.
Medical organizations strongly lobbied both the general public and the state legislators with the notions that it was in society’s interest to prevent middlemen from inserting themselves between physicians and their patients. It is necessary for the government that health care should be given the first in priority, to implement laws that can help in the protection needed for every client. The government should see to it that the status of the patients is not in danger, and the care delivery of the services in mental health was good, and the context of a managed care, is for the protection of every patient.
References: American Medical Association, Department of Data Survey and Planning, Division of Survey and Data Resources. (1999). Physician characteristics and distribution in the United States. Chicago: Author. American Medical Association, Department of Data Survey and Planning, Division of Survey and Data Resources. (2000). Physician characteristics and distribution in the United States. Chicago: Author.