?Healthcare Policy, Law, and Ethics Discussion

Healthcare Policy, Law, and Ethics Discussion “Development of U.S. Health Care in Hospitals Based on the Foundation of U.S. Law” Please respond to the following: *From the scenario, relate the basic steps in the development of U.S. health law, leading up to the present, to you or an employer’s need for health insurance coverage in light of the provisions that the Affordable Health Care Act sets forth. Rationalize the fundamental way in which these laws play a pivotal part in understanding the roles that today’s health care administrators play.Scenario Script Attached. Analyze the transition of health care from the 18th Century leading up to the 21st Century. Evaluate the degree and quality of care established within 18th Century U.S. hospitals, as compared to the level of care seen in today’s hospitals. Examine the primary roles of progressive health care law in shaping the current modern environments. ***This is a discussion, NOT a paper. Need 2 strong paragraphs and references.***
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Week 1 Scenario Script: Health Care Policy, Law, and Ethics – History of Hospitals;
Development of US Health Law; Understanding of the Foundation of Law
Slide #
Slide 1
Slide 2
Scene/Interaction
Scene 1: Exterior Strayer
University Building/Classroom
Scene 2: Interior Classroom:
? Professor Charles enters
classroom and greets students
and shares his background
? Students introduce
themselves and share their
goals for the course
Narration
Prof Charles: Hello everyone! My name is
Professor Charles Daye and welcome to Health
Policy, Law, and Ethics.
I am excited about the opportunity to facilitate
this course and look forward to engaging each of
you over the next several weeks.
I have been a hospital CEO for many years and
have obtained a law degree, a PhD in Health
Administration, and a D.B.A. in Organization
Development.
Currently, I am a CEO of a medium size
consultancy firm involving corporate
responsibility and institutional liability for all
types of health providers.
I would like to get to know a little about you and
your goals for the course.
Let’s begin with you, Casey.
Casey: Hi everyone. My name is Casey Williams.
I’m currently a Patient Advocate in a large
hospital. I am interested in healthcare
administration because I work closely with
patients and senior hospital management and I
find the work very stimulating.
After earning this degree, I would like to become
a healthcare administrator. This course in legal
aspects of healthcare administration will go a long
way in helping me to understand that part of the
job.
Donald: It’s nice to meet you Casey and
Professor Charles. My name is Donald Miller and
I’m really looking forward to learning more about
the law and healthcare administration. I have
1
always been interested in the law and caring for
people in need. Healthcare administration is my
career goal as well.
I am currently working in a private clinic and
want to major in the Health Services
Administration so I may advance my career.
Prof Charles: When you think of healthcare
administration and law management, what is the
first thing that comes to mind?
Casey: Hopefully our future career
field…(students laugh).
Donald: I agree. Sounds like a challenge, but
we’re up for it (sounding enthusiastic).
Prof Charles: Your positive attitudes are
contagious, which is a good thing. (Professor
Laughs). I’m looking forward to the next few
weeks and helping you achieve your goals. Let’s
get started.
Slide 3
Scene 3: Interior – Classroom
? Prof Charles reviews the
objectives of the course
Prof Charles: Throughout this course, you will
explore health law, theory, concepts, tools, and
case law in healthcare administration. We will
examine real cases and their applicability to daily
patient care in modern healthcare facilities and
how to prevent violations and negligence from
occurring.
In addition, we will examine emerging trends in
the health care industry that affect providing a
safe environment within healthcare organizations.
Among the topics to be covered include criminal
law, torts, theories of law, state and federal law,
ERISA, negligence, risk management, informed
consent, ancillary services, negligent
credentialing, and continuous quality
improvement in legal aspects of healthcare
administration.
During this lecture, we will examine the first
common law court case in America during 1789
and public policy as a principle of law. Public
2
policy maintains that no one can lawfully do that
which tends to be injurious to the public or
against the public good. We will also discuss
common law and its basis for the rule of law and
the rules of culture and the public good.
Prof Charles: Can someone explain the
derivation of common law and its relationship to
the public good?
Casey: I will give it a shot….I think these two
concepts, though related, have very distinct
differences. It is quite easy to confuse the terms.
Both common law and the public good go handin-hand. Common law is derived from principles
and rules during the trial of court cases. Public
policy is the principle of the laws that says, “No
one can lawfully do that which tends to do
harm to the public or against the public good.”
Donald: So, is it safe to assume that enacted laws
should support common and the U.S. Constitution
and the public good?
Prof Charles: Absolutely. Great question,
Donald.
Donald: Professor, I am still not sure that I fully
understand how common law can be abolished.
Prof Charles: Well, common law as expressed in
federal law, US Constitution, federal treaties take
precedence over the constitutions and laws of
specific states and local jurisdiction.
Casey: So you’re saying state and local laws can
only enact and enforce laws that do not conflict
with federal law?
Prof Charles: That’s correct, Casey. Statutory
laws may be declared void by a court; for
example, a statute may be found unconstitutional
because it does not comply with a state or federal
constitution, because it is vague or ambiguous, or,
in the case of state law, because it is in conflict
3
with a federal law.
Slide 4
Scene 4: Interior Classroom
? Prof Charles: Reviews the
role of common law and
malpractice
Donald: Thanks Professor, it’s beginning to make
sense to me. I am actually looking forward to
learning more.
Prof Charles: Now let’s focus on the role of the
common law in the 1794 first common law case
Cross v. Guthrey where a physician, for the first
time in America, is held responsible for
negligence in patient care, or malpractice.
Mrs. Cross developed a pain in her breast and
consulted Dr. Guthrey who amputated her breast
and she subsequently died due to bleeding. Mr.
Cross sued Dr. Guthrey after receiving a bill for
the failed operation. The lawyer for Mr. Cross
asserted that Dr. Guthrey’s bill should be
dismissed and Mr. Cross should be awarded a
significant amount of money for the loss of his
wife’s companionship. The jury concurred.
Would you agree or disagree with that ruling and
why?
Donald: I would agree that Dr. Guthrey
committed malpractice. I mean Mrs. Cross died as
a result of his surgery.
Casey: I do not agree because Dr. Guthrey tried to
relieve the source of her pain and just because
medical knowledge was not so advanced does not
mean he was negligent.
Donald: Casey provides a good argument, but
just because medicine was not advanced at the
time does not mean Mrs. Cross did not suffer a
wrongful death….
Prof Charles: That is a very interesting point of
view…Casey what do you think of Donald’s
comment about the cause of death being wrong as
a result of negligence?
Casey: Donald, makes a good point. Mrs. Cross
did bleed to death as a result of the surgery and
Dr. Guthrey should have known this was a high
4
probability.
Prof Charles: You both have made great
observations.
Since 1794, physicians have experienced
recurring periods of substantial malpractice cases.
In 1941, The Journal of the American Medical
Association published studies showing that 1296
malpractices had occurred between 1900 and
1940 with more than five-hundred between 1930
and 1940. The article said the increase was due to
high patient expectations, new diagnostic
procedures, and erosion of the physician-patient
relationship.
Scene 5
Slide 5: Interior – Classroom
? Prof Charles: Describes the
legal system
Throughout this course, we will see that the most
common reason for malpractice is misdiagnosis
and failure to follow-up. Let’s move on.
Prof Charles: Our reading reviews an
introduction to the legal system. Who can tell us
about the separation of powers?
Donald: From a reading standpoint, it is a system
of checks and balances reflected in the
relationships among the branches of government
with regard to legislation. On the federal level,
when a bill is passed in Congress and the
president signs it, a new law is created. If the
president vetoes the bill, two-thirds of Congress
can vote to override the veto.
Prof Charles: Good job, Donald. Let’s focus on
the role of the Supreme Court in this balance of
powers.
What are your thoughts, Casey?
Casey: Well, I do think the Supreme Court can
declare a bill that has become law inviolate if it
violates the Constitution.
Prof Charles: Exactly. Only those laws that are
constitutionally sound can be declared the law of
the land.
5
Even though a Supreme Court decision is final
regarding a specific controversy, Congress and
the president may generate new law and replace a
constitutionally unsound law as declared by the
Supreme Court.
Does anyone know what the Department of
Health and Human Services or DHHS does?
Casey: If I recall properly, it is concerned with
people and most involved with the nation’s
human concerns. The DHHS is responsible for
developing and implementing appropriate
administrative regulations for carrying out
national health and human services policy
objectives.
Prof Charles: Correct Casey! Healthcare
managers must understand this cabinet level
department affects the healthcare industry.
Slide 6
Scene 6: Interior – Classroom
? Professor Charles: Discusses
DHHS and its function in
society
Now let’s look at the organization’s structure.
Prof Charles: The secretary of DHHS serves as
the department’s administrative head, advises the
president with regard to health, welfare, and
income security plans, policies, and programs.
The DHHS administers the programs for senior
citizens, including Social Security benefits,
Medicare, and Medicaid and Public Health
Service, or PHS.
In your experience, what do you think is the role
of Public Health?
Casey: In my reading and experience, I think
Public Health’s role is to promote the protection
of the nation’s physical and mental health by
coordinating with the states in setting and
implementing national health policy.
Prof Charles: That’s a very accurate response
Casey.
Within the PHS of DHHS are smaller agencies
responsible for carrying out the purpose of the
6
division and DHHS: these agencies include the
following:
•
•
•
•
Agency for Healthcare Research and
Quality
Centers for Disease Control and
Prevention
Food and Drug Administration
National Institute of Health
What do you see as the thrust of public law?
Donald: I would think public law deals with
relationships between individuals and government
and private laws deals with relationships among
individuals and government.
Prof Charles: Very good, Donald. The thrust of
most public laws is to attain what society deems
to be valid public goals. One important segment
of public law, for example, is criminal law which
prohibits conduct deemed injurious to public
order and provides for punishment of those
proven to have engaged in such conduct.
In contrast, private law is concerned with the
rights and duties of private individuals. Torts and
contract law are two basic types of private law.
Now, in this discussion on the introduction to the
legal system, what do you think is tort law and
contract law?
Casey: In a tort action the plaintiff asserts that the
wrongful conduct of another has caused harm,
and the injured party seeks compensation.
Contract law involves a claim by one party that
another party has breached an agreement by
failing to fulfill an obligation.
Prof Charles: Exactly….now, do you think
anarchy would ensue without a clear system of
laws? What are your thoughts?
Casey: I guess it’s possible…
7
Donald : Yes, I do think that anarchy would be
the result without a clear system of laws that
regulate society.
Prof Charles: That’s absolutely correct, Donald.
In evaluating laws and society today, how do you
think the modern hospital is affected by the
challenges facing it?
Casey: Well, the reading tells us hospitals are
more complex than any other institution in our
society. The challenges are enormous. Hospital
challenges carried forward from the twentieth
century are exorbitant malpractice awards,
skyrocketing insurance premiums, high
expectations of patients for miracle drugs and
treatments, negative press that increase public
fear, ethical dilemmas of abortions, sterilization,
human cloning, shortages of nurses, physicians,
technicians, and other health caregivers.
Donald: I agree with Casey, and, boy, I realize
how important the job of a healthcare
administrator is and the vital need to understand
the law and health care.
Prof Charles: Excellent discussion class. The
pinnacle of the hospital evolution has not yet been
reached nor has the final page of its colorful
history been written. This is an exciting time to be
in healthcare administration.
Healthcare leaders of the twenty-first century
must understand their roots and historical value of
knowing the past, have a vision to preserve the
good and have the passion to create an even better
healthcare system to provide superior care for
patients every day. Before we move on, let’s
check our understanding with a couple of quiz
questions.
Slide 7
Check Your Understanding
Medical malpractice is a 20th
century phenomena. = False
Prof Charles: Choose the best answer to the
question and click the SUBMIT button when
finished.
Prof Charles: Medical malpractice is a twentieth
8
With this law, the plaintiff asserts
that the wrongful conduct of
another has caused harm, and the
injured party seeks
compensation. – Tort Law
century phenomena. True or False?
Prof Charles: Correct! Since 1794, physicians
have experienced recurring periods of substantial
malpractice cases. In 1941, The Journal of the
American Medical Association published studies
This law involves a claim by one showing that 1296 malpractices had occurred
party that another party has
between 1900 and 1940 with more than fivebreached an agreement by failing hundred between 1930 and 1940. The article said
to fulfill an obligation. – Contract the increase was due to high patient expectations,
Law
new diagnostic procedures, and erosion of the
physician-patient relationship.
This law deals with relationships
between individuals and
Prof Charles: Incorrect. Since 1794, physicians
government. – Public Law
have experienced recurring periods of substantial
malpractice cases. In 1941, The Journal of the
This law deals with relationships American Medical Association published studies
among individuals and
showing that 1296 malpractices had occurred
government. – Private law
between 1900 and 1940 with more than fivehundred between 1930 and 1940. The article said
the increase was due to high patient expectations,
new diagnostic procedures, and erosion of the
physician-patient relationship.
Prof Charles: Match each term with its correct
definition and click the SUBMIT button when
finished.
Prof Charles: Correct! In a tort action the
plaintiff asserts that the wrongful conduct of
another has caused harm, and the injured party
seeks compensation. Contract law involves a
claim by one party that another party has
breached an agreement by failing to fulfill an
obligation. Public law deals with relationships
between individuals and government and private
laws deals with relationships among individuals
and government.
Prof Charles: Incorrect. In a tort action the
plaintiff asserts that the wrongful conduct of
another has caused harm, and the injured party
seeks compensation. Contract law involves a
claim by one party that another party has
breached an agreement by failing to fulfill an
9
obligation. Public law deals with relationships
between individuals and government and private
laws deals with relationships among individuals
and government.
Slide 8
Slide 8: Interior – Classroom
? Professor Charles: Reviews
the sources of law
Prof Charles: Can someone describe the sources
of law?
Donald: The sources of law are common law
which is derived from judicial decisions. The
second is statutory law which comes from federal
and state statutes. And the third is administrative
law which is prescribed by administrative
agencies.
Prof Charles: Good Donald. Now, let’s take a
closer look at common law.
Today, cases are tried using common law
principles unless a stature governs otherwise.
Although statutory law has affirmed many of the
legal rules and principles initially established by
the courts, new issues continue to arise, especially
in private law disputes, which require decision
making according to common law principles.
Common law actions are initiated mainly to
recover damages or possessions of real or
personal property.
Casey: Do the lower state courts have to follow
higher state court common law principles?
Donald: I’ve read that lower state courts must
follow higher state court principles of common
law.
Prof. Charles: That is correct. Consider the fact
that a decision in a case in higher state court that
sets forth a new legal principle establishes a
precedent. Trail courts or those on equal footing
are not bound by the decision of other trial courts.
Also, a principle established in one state does not
set precedent for another state.
10
Slide 9
Scene 9: Interior – Classroom
? Summary
Casey: OK…that makes sense….
Prof Charles: Today, we have had a great
discussion on the basics of the history of hospitals
and an introduction to the legal system as it
relates to health care.
To recap today’s highlights, we discussed the
sources of law and government organizations and
how laws seek to solve problems, seeking to settle
them without resorting to force. The history of
hospitals we have seen reveals errors that then can
be avoided, customs that persist only because of
tradition, and practices that have been superseded
by other that are more effectual.
During the next lecture, we will discuss tort law,
negligence, and criminal aspects of health care
and its place in preserving the peace. I look
forward to another great discussion during our
next meeting.
Before we adjourn, are there any questions?
Donald: No questions for me. I learned so much
today and I’m ready for more.
Casey: Same here, I’m looking forward to our
next meeting.
Professor Charles: Excellent! Don’t forget to
participate in this week’s discussion and complete
the e-Activity as well. If there are no further
questions, I will say good evening and I will see
you next time.
11

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