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Health Care Management involves all practices that ensure that health care services are availed to the members of public reasonable costs. It involves bringing together all parties that are involved in provision of health care services such as doctors, physicians, nurses, healthcare insurance companies, government and other state regulated private organizations that provide the public with health care services (Gauld, 2005). Health Care Management is therefore one of the most challenging tasks in the contemporary world due to its diversity. Some of the major challenges associated with Health Care Management include social related challenges, legal challenges, economic challenges and ethical challenges among others. A good case representation of legal and ethical issues associated Health Care Management is the 2002 film “John Q”
John Q is 2002 film that stars Denzel Washington as John Quincy Archibald who is a father and husband. The movie reflects on the situation of Health Care Management in our societies and how little concern is given to the ordinary non-wealthy members of the society in some countries. John’s son is diagnosed with an enlarged heart and he cannot receive transplant because Health Maintenance Organization (HMO) insurance could not cover surgery expenses (Wehner, 2003). After trying all ethical means to save his son John opts to unethical and illegal means where he decides to take hospital, as well as the present patients, hostage until the name is put on the recipient’s list of the available heart. As the film opens, a young woman is seen driving a BMW car recklessly down a mountain highway. The woman tries to carelessly overtake a slow moving truck on a curve. Another truck looms in the oncoming lane resulting to an accident where the woman dies.
The whole saga started when Michael (John’s) collapsed base ball field after complaining of chest pain. After undergoing several tests it was confirmed by Dr. Raymond and Rebecca the hospital administrator that Michael had and enlarged heart and only a transplant could save. However the company that John was working for had dropped him from full time to part time and consequently his health insurance had been changed from Preferred Provider Organization (PPO) to Health Maintenance Organization (HMO) (Flanagan, 2007). John was therefore required to pay more money in order to have his son undergo heart transplant. It is unethical for the hospital to fail to operate Michael on the basis that his father could not raise the enough amount of money (Common Cause, 2010). On the other hand, the hospital administration required that a person should pay a certain amount of money before commencing of an operation. It is also unethical for John’s employer to change his health insurance from PPO to HMO thereby making it difficult for him to access health care services. On the other hand, there were legal requirements that John’s health care insurance be changed from PPO to HMO after his employment changed from full time to part-time. All in all the head result of this act is unfair health care services provision (Flanagan, 2007).
After waiting for Michael’s parent to raise medical fee for long time in vain, the hospital decides to release him without treatment. It was unethical for the hospital to discharge Michael without treatment on the bases of insufficient funds. Ethically, the hospital is supposed to first of all save life and then have its expenses paid. However, this could not happen since there were hospital rules that required patients who could not raise hospital fees are discharged (Landers Associates, 2008).
After pressure from his wife Denise and the news of the discharge of their son from the hospital without the operation, John decide to try unethical means to save his son and this made him end in jail. John walks into the hospital emergency room with a handgun and he held everyone hostage. John demanded that his son be attended soonest possible before he could release his hostages. The situation got very serious and it called for the intervention of the policy with the negotiator being Lt. Frank Grimes. Among hostages, there is Miriam who is pregnant, her husband Steve, Julie (who has broken arm), her boyfriend Mitch and Lester. It is unethical and illegal for John to use force and fire arms to hold hospital hostage there by paralyzing all the activities in the hospital. Julie and Mitch seem to have fought and it is unethical of then to lie that it was minor accident. It is also unethical for the hospital to make patients wait at the emergency room where medical attention is urgent (Landers Associates, 2008).
After some negotiation John starts releasing his hostages on one by one. Later on Chicago Chief of Police, Gus Monroe gives a SWAT unit permission to intervene the situation and John is heard telling his wife that all was going to be fine. The news crew had hijacked one of the hospital’s hidden camera and his conversation and emotions were being aired live on a national television. This is not only unethical but illegal. John realizes that his phone call is being broadcasted and suddenly he shot by a sniper but he is slightly injured. After realizing that his violence was not solving his problems, John threatened to kill himself so that his heart could be used to treat his son. This too is unethical and illegal. Before John Kills himself, it is realized that the woman who had died on a road accidents at the beginning of the film had the same blood group with Michael and he was being airlifted to the hospital for organ recovery. Eventually Michael is given a life saving operation and his dad ends to Jail (Ebert, 2005).
Generally the film is full of ethical and legal issues associate with lack of proper health care management. It is unethical for the media crew to hijack the hospital camera in order to air John’s situation bearing in mind that they had failed to help his raise money. It is also illegal and unethical for John to try to kill himself although he heard ethical intentions to save his son (Craddock, 2005). John is later charged of attempted murder and armed criminal action but is found guilty of kidnapping. It is ethical to use heart from the lady who had crashed in an accident to save Michael. It is clear from the film that good health care services cannot be attained without good legal systems and desire from the people to practice ethical actions (Northwestern University, 2011). It is also evident that just like John did, there are other people in our societies who get involved into unethical and illegal actions as they try to access good health care services.
Healthcare provision in Singapore is indirectly the responsibility of Singapore people through the management of the Singapore government‘s Ministry of Health. Singapore has one of the countries that have efficient and widespread healthcare system. In fact it is ranked 6th by the World Health Organization’s in its ranking of the world’s health systems in the year 2000 (Woodman, 2009).
Singapore healthcare management is far much better that USA which was the setting of the film “John Q”. Singapore has established efficient healthcare management for its citizens where modified universal healthcare system is established by the government to ensure healthcare services is affordable to all people regardless of their wealth. Generally, Singapore has established a healthcare system that has enabled people to contribute for their health care services depending with their earnings and this has eliminated exploitation of the poor by the rich. Legal and ethical requirements in Singapore Healthcare management have also contributed to its remarkable healthcare system (Woodman, 2009).
The film, John Q is can be viewed as the representation of how healthcare in Singapore could be if the country did not take good measures in management of its healthcare. The implication that ethical and legal issues witnessed in the film ‘John Q’ is that Singapore should continue with its efforts to boost its healthcare services in order to avoid situations where people will have to use force and firearms to demand for healthcare in their own countries. The unethical and legal systems witnessed in the movie can serve as an example of how bad healthcare services are in other countries due to lack of effective political, economic and ethical support from all stakeholders (Gauld, 2005). Singapore can also used the ethical practices witnessed in the film to improve its healthcare management in order to ensure that its citizens do not strain to access basic and expensive healthcare services like John and is family in the film.