Analyzing the Declining Trust Crisis in the US Healthcare System

This essay examines the declining trust in the US healthcare system, utilizing the four principles of biomedical ethics (autonomy, beneficence, non-maleficence, and justice) to analyze the problem. It explores how legal issues, such as the violation of patient autonomy and disparities in healthcare access, contribute to this crisis. Economic and financial factors, including high healthcare costs, insurance issues, and the high cost of prescription medication, are also discussed. The essay highlights the impact of these issues, including low-quality care, waste in healthcare spending, healthcare fraud, and the financial burden on a small percentage of the population. The author proposes reducing healthcare costs through value-based payment methods as a modification to increase public trust. The essay concludes by emphasizing the importance of prioritizing patient needs to improve trust in the US healthcare system.

Running head: THE TRUST CRISIS 1
Declining Trust in the Health Care System (The Trust Crisis)
Name
University

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Introduction
The four principles biomedical ethics model will be used to address the problem because
it identifies ethical issues and the optimal action taken when performing ethical assessments
(Beauchamp & Childress, 2001). Autonomy states that a patient should have informed consent
and cannot be treated without consent except in clearly defined situations (2001, p.66). The trust
crisis arises when doctors assume an authoritative position over their patients without achieving
consent (2001, p. 60). Beneficence requires practitioners to perform actions that are meant to
promote the interests of their patients (2001, p.166) while non-maleficence means avoiding harm
(Beauchamp & Childress, 2001, p.114). Trust declines when doctors perform medical treatments,
they deem suitable for their patients but which the patients find detrimental. The principle of
justice refers to the equal provision of healthcare regardless of the patient’s socio-economic
status (2001, p.226) and it affects trust when there is inequitable access to healthcare.
Legal Issues Contributing to the Trust Crisis
In cases where a patient decides to forego treatment because of quality of life, legal issues
arise when the treatment is imposed against the patient’s wishes, violating their autonomy and
informed consent (Summers, 2014). A second issue deals with distributive justice in terms of
resources and the disparities that exist in healthcare. These disparities lead to discrimination
where people who pay more for healthcare receive better treatment while those who can’t afford
it receive poor quality care (Summers, 2014, p.47).
Economic and Financial Issues Contributing to the Trust Crisis
In 2013, 56 million people in the country found it difficult to pay their healthcare costs
while those with insurance found it hard to pay the deductibles amounting to $5,000(Amadeo,

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2018). This high cost of healthcare creates a second problem where many people opt out of
taking prescription medication because they cannot afford it. For example, a patient found it hard
to pay $1,200 per month for insulin, opting to reduce her dose which in turn made her condition
worse (Amadeo, 2018). This example demonstrates injustice in healthcare.
Impact of Various Issues Contributing to the Trust Crisis
The biggest issue is high insurance costs where people lacking insurance have a higher
chance of experiencing problems such as low-quality care, high medical costs and poor health
access (Armstrong et al. 2006). The second problem is the huge amount of healthcare spending
that goes to waste every year. Physicians overprescribe medication amounting to wastes of $210
billion per year while administrative costs total $190 billion because of processing insurance
claims (Amadeo, 2018). The third issue is healthcare fraud which causes losses of between $60
to $200 billion each year. Fraud leads to higher insurance costs which in turn increases premiums
and prices for laboratory tests and medical procedures (Amadeo, 2018). The fourth issue is that a
small percentage of the American population contributes to healthcare costs which translates to
one percent of the population incurring healthcare costs of up to 20%, increasing the burden of
those paying for health insurance (Amadeo, 2018).
Modification to Increase Trust in the Health Care System
One modification that can improve public trust is reducing healthcare costs by paying
according to an anticipated value. The current payment methods lead to higher healthcare costs,
unnecessary medical treatments, penalization by insurance providers and barriers to quality care.
Providing patients with bundled methods of payments reduces these problems and it leads to
better quality care with lower health costs (Yong, Saunders & Olsen, 2010, p. 35).

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Conclusion
Reducing the cost of healthcare and insurance is a way of improving people’s trust in US
healthcare. Putting the needs of the patient’s first will ensure they receive the right care at
affordable costs.

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References
Armstrong, K., Rose, A., Peters, N., Long, J.A., McMurphy, S., & Shea, J.A. (2006). Distrust of
the healthcare system and self-reported health in the United States. Journal of General
Internal Medicine, 21(4), 292-297. Retrieved 3 November, 2018, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484714/.
Amadeo, K. (2018). Health care costs facts: awful truths about the cost of healthcare in
America. Retrieved 3 November, 2018, from: https://www.thebalance.com/healthcare-
costs-3306068.
Beauchamp, T.L., & Childress, J.F. (2001). Principles of biomedical ethics. New York, NY:
Oxford University Press.
Summers, J. (2014). Principles of healthcare ethics. In E.E. Morrison & B. Furlong (Eds.),
Health care ethics: critical issues for the 21st century. Retrieved 3 November, 2018, from
http://samples.jbpub.com/9781284124910/9781284124910_CH02_OnlineCat.pdf.
Yong, P.L., Saunders, R.S., & Olsen, L. (2010). The healthcare imperative: lowering costs and
improving outcomes. Washington, DC: The National Academic Press.