Case Study 3 Making Cut In A Health Department Budget

Module 9: Case Study 3
Making Cuts in a Health Department Budget
Elizabeth Mahan
HCA415: Community and Public Health
Instructor: Kristin Akerele
April 1, 2017

Module 9: Case Study 3
Making Cuts in a Health Department Budget
1. Explain how the four bioethical principles should guide budgetary decisions in the public health realm. The bioethical principles are autonomy, beneficence, maleficence, and justice.
Non-maleficence means to “first do no harm”. In a clinical setting, do no harm could suggests to ensure that a condition does not worsen on purpose. Autonomy is a concept in which the patent is self-ruling. The physician must not leave the patient out of any options and give decisions regarding care. Beneficence is a Hippocratic
Examine how these final decisions were made in terms of: who should have a voice in this decision, how many and which stakeholders should be involved, what rules of discourse should be followed and how would you reach that final decision (i.e. what is the deciding factor).
Stakeholders in healthcare are the patients, providers, payers, and employers. All stakeholders typically have input regarding decisions however, as it relates to budgetary issues the providers, and employers would most likely have the final say. However, in the U.S. there are currently issues relating healthcare at the government level that will affect The Affordable Care act. The current president Trump is attempting to get a bill passed called the American Healthcare Act to replace The Affordable Care Act due to high premiums to some Americans whom are “over income”. The rules that should be followed are per the governmental laws already in place in addition to the four bioethical principals discussed.
3. Describe the ethical norms that should be essential in deciding the reduction or expansion of a public health
As it relates to well -child care, requirements for immunizations for school aged children may have to be altered.

2. Impact on Administration and Programs: Reduce funding to county health departments to make flexible strategies for local priorities.
A “No Cost” alternative: instead of reducing funding to county utilize the same funds to increase access to county health departments in major areas.
5. Imagine you suddenly came into enough funding to reinstate one of the bulleted items on pages 263-264. Reviewing these elements under the four bioethical principles, which (if any) would you add back into the budget and why? If you did not add any of these back into the budget, what would you do with the extra funds? Explain to your stakeholders why you came to your conclusion.
After reviewing the bioethical principals, the element to be reinstated first would be the state funding of the Child Health Program. Healthy children aides in healthy adults as well as keeps pandemics or epidemics low which in turn reduces health care costs. Bioethical principals tend to be viewed as a moral obligation however, the Child Health Program can be viewed as a preventative measure as well.