Needing New Ethics: Religious Resources for the Shift from Clinical Care to Population Health
Michael Rozier, MPH, Doctoral Student, University of Michigan
The Affordable Care Act and the widely accepted Triple Aim are inciting a shift to population health in US health care. Drivers such as the reduction of payments for preventable readmissions, new partial capitation Accountable Care Organizations, and new reporting requirements for Community Benefit are responsible for this shift. While clinical care will remain the core competency of health care delivery organizations, we have begun to see a growing concern with preventing illness and promoting health in “attributed populations” and surrounding communities. Although health care organizations are currently focused on the medical, financial, and managerial aspects of this change, we should also be attentive to what this means for the ethics of health care organizations, many of which have religious motivations.
The rise in concern for population health requires moral and ethical reflection and will need to draw upon new resources or apply existing resources in new ways. In this presentation, I will explore the ways in which two major religious traditions have framed the individual and population concerns for health over time. Because religiously affiliated hospitals in the US are generally Christian or Jewish, I offer moral resources from each tradition to aid in our reflection as we shift from clinical care to population health. The importance of clinical bioethics will not diminish. Rather, this project is aimed at anticipating a new need and ensuring that moral resources are available for those charged with achieving health for individuals embedded in a population.
The development of public health ethics has begun to address this need but its basic frameworks are more adequate for health systems rather than health care organizations. Moreover, religious voices have been rather silent on the turn toward the public. They need not be. We must therefore ask, what are the paradigmatic examples in Scripture or Tradition that scholars of these faiths can use to understand this issue? What are the intellectual resources these faiths draw upon to shape their anthropology or sociology? What kind of barriers can be anticipated from clinical health care when considering an analysis from the population level? These questions will help illuminate the religious resources we can use as medicine pairs its expertise in clinical care with a need for population health. Both health care organizations and individual providers will be faced with competing pressures during this shift. We would do well to help resolve such pressure in ways that resonate with US health care’s major religious traditions.
The Affordable Care Act and the widely accepted Triple Aim are inciting a shift to population health in US health care. Drivers such as the reduction of payments for preventable readmissions, new partial capitation Accountable Care Organizations, and new reporting requirements for Community Benefit are responsible for this shift. While clinical care will remain the core competency of health care delivery organizations, we have begun to see a growing concern with preventing illness and promoting health in “attributed populations” and surrounding communities. Although health care organizations are currently focused on the medical, financial, and managerial aspects of this change, we should also be attentive to what this means for the ethics of health care organizations, many of which have religious motivations.
The rise in concern for population health requires moral and ethical reflection and will need to draw upon new resources or apply existing resources in new ways. In this presentation, I will explore the ways in which two major religious traditions have framed the individual and population concerns for health over time. Because religiously affiliated hospitals in the US are generally Christian or Jewish, I offer moral resources from each tradition to aid in our reflection as we shift from clinical care to population health. The importance of clinical bioethics will not diminish. Rather, this project is aimed at anticipating a new need and ensuring that moral resources are available for those charged with achieving health for individuals embedded in a population.
The development of public health ethics has begun to address this need but its basic frameworks are more adequate for health systems rather than health care organizations. Moreover, religious voices have been rather silent on the turn toward the public. They need not be. We must therefore ask, what are the paradigmatic examples in Scripture or Tradition that scholars of these faiths can use to understand this issue? What are the intellectual resources these faiths draw upon to shape their anthropology or sociology? What kind of barriers can be anticipated from clinical health care when considering an analysis from the population level? These questions will help illuminate the religious resources we can use as medicine pairs its expertise in clinical care with a need for population health. Both health care organizations and individual providers will be faced with competing pressures during this shift. We would do well to help resolve such pressure in ways that resonate with US health care’s major religious traditions.