Economics of End-Stage Renal Disease Essay

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To that end, patients who opt to pay more are likely to have better access to treatment; meaning, essentially, that patients who choose to go with commercial healthcare providers will have more accessibility and better quality of treatment as opposed to those who depend upon CSM or the government. Patients who go with a commercial healthcare provider such as Fresenius, for example, may be paying considerably more than someone whose costs are financed by CMS or the government. However, that person will certainly be granted treatment (particularly if it involves dialysis), although the expenses will be considerable for medication such as erythropoietin. However, those who opt for CMS or governmental services have to cope with the fact that the former organization is treating fewer and fewer of its population for ESRD, while those relying on the government may well see the effects of cost shifting. Those fortunate enough to in fact receive treatment by these two organizations, however, will be responsible for a substantially lower amount of payment than those who go with commercial healthcare providers.

The ethical implications of treatment options based upon cost evaluation, therefore, are fairly salient. To a certain extent, the options for patients regarding cost of treatment, accesses to treatment and quality of treatment resemble a scenario in which those select few with the personal finances able to procure service through health care providers will be able to obtain curative measures effective enough to cope with ESRD. This point is reinforced by the fact that if CMS is able to meet its goal of breaking even, a plethora of ethical considerations involving "a loss of investment in the industry, facility closings (especially for smaller competitors in the industry) and decreased quality" (243).

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Were these events to actually transpire, then the actual value in providing healthcare services would significantly decline due to the poor quality, the consolidation of treatment facilities -- which could likely lead to some unbalanced monopolies -- as well as the overall lowering of standards of the industry. From an ethical perspective then, it would be highly difficult to justify a rapid decline in the service of providing treatments that people need in order to sustain their lives, for the simple fact of meeting a budget. At the same time, however, there are necessary components of such considerations, since organizations need to be cost effective in order to stay in business and provide any type of service......

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