Healthcare in the United States: Sources of Medical Laws

Question 1

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Particular legal standards govern the healthcare practice. Medical laws are defined as laid down and enforced social rules which outline the legally required and prohibited conducts. For that reason, those who break the set rules are liable to criminal charges as per the civil laws of a state.

Sources of Medical Laws

For instance, in the United States, laws are encoded in the national and state constitutions. Here, the existing relationship between the governed citizens and the government is clearly outlined and described. For example, the federal government regulates health care through the state police powers, where hospitals are monitored and controlled to maintain a sustainable environment. On the other hand, the Medicaid regulatory body ensures that financial help is guaranteed without discrimination (Turnock, 2011). In addition, clinical laws are derived from state or federal statutes, which are created and implemented by legislative bodies or the citizens. The sole purpose of legislations is to influence the efficacy of health care delivery. For example, through statutory laws, states can demand more home visits by nurses, authorize necessary programs, prohibit or mandate the occurrence of health-related activities, and provide regulations for resource distribution to hospitals. Lastly, medical laws are written on the national and state regulatory agencies; for instance, the American Nursing Association and the leading public agency Centers for Disease Control and Prevention (CDC) (Turnock, 2011). Regulatory bodies delegate and enforce rules as laid down by the legislature. Moreover, these agencies ensure efficient local boards, each department delivers on its work, establish health-related laws, and make budgets or programs associated with medical issues.

Question 2

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Administrative agencies perform various functions, including monitoring the health issues of people in the country, detecting any disease outbreaks, formulating, developing, and implementing health policies to reduce infectious diseases and their fatalities (Thomas-Brogan, 2009). Agencies are also acknowledged for representing vulnerable community members and actively supporting governmental policies that are designed to help improve the poor conditions in the societies.

Examples of Agencies

America has many administrative agencies, including the American Medical Association (AMA), which promotes medical sciences for the efficacy of societal health. There is also the World Health Organization (WHO), an international organization that ensures that global health issues are addressed, allows the usage of evidence-based policies, provides technical support for countries, monitors and assesses any health-related trends (Thomas-Brogan, 2009). The Food and Drug Administration (FDA) ensures that people are protected and provided with educative materials of biological products, cosmetics, foodstuff, medical devices, and radiation-emitting commodities. Another administrative agency is Medicare centers where people with low incomes, the elderly, and the poor are provided with quality health care needs. In addition, there is the Centre for Disease Control and Prevention (CDC), whose primary duty is to educate the American public, prevent the spread of infections, and carry out research on any diseases within America. Administration for Children and Families (ACF) provides financial support to families for child support, care, and the kid’s welfare (Thomas-Brogan, 2009). Another important agency is the Indian Health Service (IHS), which ensures that American Indian and Alaskan natives are provided physical, social, spiritual, and mental health services within the US.

Question 3

Criminal laws are crimes against the state, mostly provoked when an individual violates the encoded public rules and regulations. On the other hand, civil or tort legislation charges people for committing a crime against fellow citizens (Ramutkowski et al., 2005). Torts are mostly provoked when a person is injured, face damages, or deprived of freedom.

Similarity

Both laws are similar in that they are used to show that the charged person has violated the laid down social regulations. While criminal laws represent a violation of public laws, torts argue that an individual has violated the rights of a fellow person. In health care, mostly, criminal laws are applied if a practitioner practices without a valid license, which is a legal requirement by the state (Ramutkowski et al., 2005). On the other hand, tort laws are seen if a professional disregards a patient’s privacy or neglects their responsibilities as required by the law, thus harming the life of the affected person and exposing a patient to danger.

Contrast

The significant difference between the two is that criminal laws have larger consequences in comparison to tort charges. Illegal activities, whether in the form of a felony or misdemeanor, can lead an individual to face serious punishments, including heavy fines, life imprisonment, or death. However, tort charges mostly involve fines, mostly in small amounts compared to those of criminal laws (Ramutkowski et al., 2005). Moreover, an unintentional tort that mostly comes in the form of negligent practitioners only becomes a punishable civil issue if at all they determine whether the actions perpetrated coincide with professional malpractice.

Question 4

Health care practitioners are employed on a contract basis. Agreements are used to show that two parties approve and are bound by specified terms where they promise to deliver as provided on this binding document (Ramutkowski et al., 2005). In fact, fully valid contracts, however, are characterized by various elements.

Elements

The first is a valid agreement where the contract will show the party making the offer and the one accepting it. Notably, the proposal should exemplify the present and the future, understandable and formal (Ramutkowski et al., 2005). For example, in healthcare, the professionals are bound by a contract that only allows them to practice medicine with a valid license, in turn, the employer ensures to abide by the stipulated agreement and pay the physician according to the quality of services delivered.

A contract should also be structured with plenty of consideration. By so doing, a valuable service will be bargained for and provided as per the laid down agreement (Ramutkowski et al., 2005). For example, in health care, a contract should be designed in consideration that the health practitioner agrees to offer the required services while patients ensure to pay the fee incurred during the entire process.

Another crucial element is a well-outlined subject matter. In this case, the legality is critical as it shows that the contract is valid and applicable in a court of law. If an agreement lacks this element, it becomes impossible for a person to use it in a jurisdiction or enforce it in any legal matter. For example, in health care contracts are often seen as null or void if a patient and a physician do so in private agreements due to the absence of legal procedures (Ramutkowski et al., 2005). Nonetheless, refusal to comply with a legal document is seen as a breach of contract, which can lead to a lawsuit.   

The other element required is adequate contractual capacity, where each party is offered a chance to understand the full requirements of the contract and synthesize all the terms and conditions involved. Therefore, mentally ill individuals cannot sign an agreement, as their psychological wellbeing does not allow them to do so as per the law.  

Question 8

HIPAA was initially formed to help improve health care coverage within insurance markets, reduce wastage, fraudulent activities, and abuse of hospital insurance policies. HIPAA has two crucial elements where the first addresses health care portability, and the second prevents fraud or misuse of medical funds, simplifies the process, and deals with liability reforms in this sector. Through HIPAA, individuals are guaranteed protection, as companies are restricted from excluding people from acquiring or renewing their policies due to preexisting conditions (Ramutkowski et al., 2005). Moreover, through this medical Act, small employers or individuals are guaranteed the right to purchase any insurance coverage as per their financial capability.

HIPAA is also essential as it ensures privacy for patients, especially regarding their health information. Through the privacy rule, patient information is now disclosed and stored through Protected health information (PHI) transmission method, which is facilitated by the readily available electronic media (Ramutkowski et al., 2005). Therefore, patient records are now easily accessible but only restricted to those with covered entities alone, a law prohibiting health care professionals from disclosing or sharing the information gathered to outsiders. Further, the PHI procedure is crucial as it ensures that an individual’s information is collected from the past, present and future, proper treatment methods are provided, and billings are made per the services rendered. Therefore, when PHI is abused as mandated by HIPAA, a health facility or staff member charged with this breach of contract faces serious criminal or civil penalties.

 

References 

Ramutkowski, B et al., (2005). Legal and ethical issues in medical practice, including HIPAA. Administrative Procedures for Medical Assisting, 37-58.

Thomas-Brogan, T. (2009). Introduction to health care delivery systems. Health Information Technology Basics, 1-30.

Turnock, B. J. (2011). Law, government, and public health. Public Health, 77-104

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