Responsibilities of Nonprofit Health Care Organizations

The existence of nonprofit healthcare organizations is essential in the provision of affordable healthcare to many Americans who would otherwise find it hard to get treatment elsewhere. These organizations are therefore very important and according to Dewar (2009) they are divided in to three main categories. The first are organizations which are populated by a general membership in a specific industry and a very good example of this is the American Medical Association. The second category comprises of those organizations which are mandated to provide services towards a specific therapeutic problem such as cancer, diabetes, among others and an example of this is the American Cancer Society. The third and final category are nonprofit organizations which are founded and operated by private citizens whose main aim is to help anyone they choose to help and one of the most prominent of these organization is the World Vision Foundation.

The GAO Report on nonprofit hospitals states that the Federal tax exemption for charitable organizations has been in existence since the beginning of the federal income tax law and it is based on the assumption that the loss of government tax revenue is offset by the ability of these charitable organizations to provide for the population’s welfare. One of the greatest beneficiaries of this tax exemption system has been the nonprofit hospitals due to the belief that the promotion of medical healthcare especially to the poor is a charitable function and should be exempted from taxation. The IRS et al (1993) states that one of the main conditions for this exemption is that these hospitals should be organized and operated exclusively for the purpose of the provision of health and that all the income it generates should not go to the benefit of individuals within this organization but should be put back into pursuing the main objectives of such an organization. Furthermore, nonprofit hospitals do not have to provide free medical services in order to qualify for tax exemption so long as they provide services to the community which will reduce the government’s financial burden. In relation to this, the clinics operated by the Memorial Medical Center help it to maintain its tax exemption status due to the fact that these clinics were opened for the purpose of providing better healthcare services to the communities within which they are situated. The operation of these clinics provides it with the means for it to ask for exemptions because they provide the services which the government should be providing and it has also been seen that the provision of these services comes at great expense to the Medical Center considering the losses that are incurred in one of the clinics.

The article An Organizational Ethics Decision-Making Process by William Nelson looks at the steps that can be undertaken by the Memorial Medical Center when making decisions that are related to ethics in order to satisfy all the stakeholders in making the decision of whether to close a loss making clinic or not. The first which is to be considered is the clarification of the ethical issue in question and the parties involved should be able to declare the specific areas where they are in disagreement. The second step is the identification of all the affected stakeholders and giving them the opportunity to express their views concerning the ethical issue involved. A third step is understanding the issues surrounding this ethical conflict and this requires fact finding missions to find out exactly what its root cause is, be it medical, financial, or the community. The fourth step is the identification of the ethical perspectives that are relevant to this conflict from the different views from which it can be seen. The fifth step is the identification of the different options that are open to respond to this issue such as adopting new strategies to stop the financial drain that it has been experiencing. The sixth step is the analyzing the different options identified in the previous step to look for their merits and demerits and to determine whether the opinion of one stakeholder appears to be stronger that those of all the others. The seventh step is to share and implement the decision with all the people concerned. The eighth step is the reviewing of the decision to see whether its implementation managed to achieve the desired goals that it was intended to achieve. There are several options open to the Medical Center including the following: keeping the loss making clinic open and continue running it at a loss, appealing to the government for more tax exemptions in order to get more funds to run this clinic, and finally, it can decide to close the clinic. I believe that the Medical Center should choose the second option because it will enable it to be able to continue operating the clinic with minimal or no losses at all due to the fact that it is getting more tax exemptions. It would not be ethical for the Center to close up its clinic because many people living in that area rely heavily on it due to its affordability.

Nicholson et al (2000) states that it is the ethical obligation of non-profit hospitals to provide medical healthcare to all the people who come to it not only to maintain their tax-exempt statuses but also as a way of contributing to the society.  It is therefore not acceptable for such a hospital to only do the barest minimum to maintain its exemption status because that can only be considered to be illegal. Instead, it should do its utmost to provide the necessary services to justify why it should have any tax-exemptions.

Cited Works

Dewar, D.M. (2009). Essentials of Health Economics. Burlington, MA: Jones and Bartlett Learning.

Government Accountability Office. (2008). Report to the Ranking Member, Committee on Finance, U.S. Senate. Retrieved from http://www.gao.gov/new.items/d08880.pdf

Nelson, W.A (2005). An organizational ethics decision-making process. Healthcare Executive, 20(4), 8-14.

Nicholson, S., Pauly, M. V., Burns, L. R., Baumritter, A., & Asch, D. A. (2000). Measuring community benefits provided by for-profit and nonprofit hospitals. Health Affairs, 19(6), 168-77. Retrieved from http://0search.proquest.com.alice.dvc.edu/docview/204632733?accountid=38376

Tax exemption granted to nonprofit charitable hospitals that accept payment for services rendered.(1997). The Appraisal Journal, 65(4), 420-420. Retrieved from http://0search.proquest.com.alice.dvc.edu/docview/199949607?accountid=38376

United States Internal Revenue Service. Statistics of Income Division, American Statistical Association. (1993). Statistics of Income: Turning Administrative Systems into Information Systems. Washington D.C: Government Press.

The re-emergence of disease once believed eradicated or controlled in modern society

Chugh (2008) states that one of the biggest health threats to the public is the reemergence of diseases once believed to have been either eradicated or controlled due to the fact that common bacteria are increasingly developing resistance to antibiotics. This new threat has the ability to reverse all the progress that has been made against diseases since the development of penicillin, due to the fact that diseases such as gonorrhea, meningitis and tuberculosis are developing strains which are drug resistant. A possible reason for this is the current overuse of antibiotics as well as the use of antibiotics on livestock in order to promote their growth. It is a very difficult task to track down these new drug resistant strains of diseases and there is yet to be agreement on how best to deal with this situation. Bettelheim (1999) states that these new strains, after tests were done, were shown to have acquired genetic traits which enabled them to evade most of the conventional lines of pharmaceutical attack, and if left unchecked, they could severely limit the ability of doctors to control dangerous infections. Furthermore, these drug resistant strains would make even the simplest operations into potentially life threatening situations.

There has been news of outbreaks of infectious diseases not only in the United States but also all over the world. According to Krause (1992) diseases which were once thought to have been eradicated, such as polio, are slowly reemerging and very little can be done to stop then due to the fact that they are drug resistant. There are increasing cases of new infections by such strains everyday and these contagions have been making powerful impressions all across the world and many states have chosen to give them special attention in order to develop new ways of eradicating them. Cherry (2010) declares that in the United States, there have been cases of whooping cough especially in California in 2010 where over nine thousand cases were reported with several infant deaths. Kim (2007) states that the most common symptoms of whooping cough are having a runny nose, sneezing, low grade fever, and a mild occasional cough which is similar to the one experienced when having a common cold. Later there develop numerous bursts of coughing accompanied by a long effort to breath in. between episodes, the person infected may appear to be in a normal condition, but in infants, they appear to be very ill. There have been cases where immunization programs have been interrupted due to the belief that the fight against the various infectious diseases has been won and this has enabled the reemergence of these diseases that have resisted the drugs available. Furthermore, the resistance against such diseases has been greatly reduced because of the lack of resistance in human beings.

There are several reasons why the diseases which were once thought to have been eradicated or controlled are reemerging. Esmaeil (2008) states that one of these is the fact that some disease causing bacteria have acquired genes which enable them to resist the drugs which are administered to eradicate them. Another reason is that there is an abundant use of antibiotics and this has enabled the bacteria to develop resistance to drugs. Lastly, the use of antibiotics in livestock to encourage their growth has enabled bacteria which were previously confined to animals to get transmitted to human beings and these have transferred their genes to human bacteria enabling them to survive. Examples of these drug resistant diseases that are reemerging are the tuberculosis and poliomyelitis. Wang (2012) says that there have been cases of doctors refusing to give any medical care to children who have not been immunized because their parents were concerned that vaccines causes autism and other medical problems. The refusal of these parents to have their children vaccinated leaves them vulnerable to attacks from new strains of diseases which can turn out to be infectious and life threatening not only to these children and to others.

Tuberculosis was once a major health problem whose prevalence declined dramatically due to the development of vaccines against it. According to Shields (2005) with the emergence of HIV, tuberculosis has reemerged as an opportunistic infection, developing new drug resistant strains which physicians are finding difficult to treat. This disease has developed resistance to many of the antibiotics which are used to treat it mainly through genetic exchange or mutation or the long term use of antibiotics.

Governmental entities all over the world are finding it very hard to control the reemergence of diseases once thought to have been controlled. Moyers (2012) declares that the cultural and religious beliefs of people tend to influence them into resisting the use of vaccines because of the suspicion that some of these cultures have against them. There are religious practices which do not allow the use of vaccines because of the belief that it is the will of God if one gets a disease and it is not the responsibility of human beings to go against his will. This belief is especially prevalent in the religious practices of the Middle East and the Taliban influenced Afghanistan. European views concerning vaccination are also beginning to change with many parents believing that vaccines negatively affects the health and well being of their children and this increases the resistance to vaccination.

. In conclusion, it is best to educate and get the public to be aware of the existence of these reemerging diseases so that they are better able to protect themselves. State and federal laws should be put in place to ensure that parents are not allowed to opt out of vaccinating their children in order to reduce the risk of a rapid spread of reemerging diseases. There is a risk of the developing of more reemerging diseases and we should be ready for them by the provision of more information to the public concerning the benefits of preventative vaccination.

Cited Works

Bettelheim, A. (1999). Drug-resistant bacteria. CQ Researcher, 9, 473-496. Retrieved from http://0-library.cqpress.com.alice.dvc.edu/cqresearcher/

Chugh, T. D. (2008). Emerging and re-emerging bacterial diseases in India. Journal of Biosciences, 33(4), 549-55.

Kim, C. (2007). Pertusis: A re-emerging threat. The Journal for Nurse Practioners,

Krause, R. (1992). The origin of plagues: old and new. Science 257:1073-1078,

Cherry, J. (2010). The present and future control of pertusis. Editorial Commentary,

Retrieved from http://cid.oxfordjournals.org

Esmaeil, Z. (2008). Emerging and re-emerging zoo noses. Iranian Journal of Clinical Infectious Diseases, 2008(3(2):109-115), www.middle-east-online/english/?id=51041

Moyers, B. (2012). The risk of contagion nation. Middle East online, Retrieved from http:w Caladrillo, P. S. (2005). American law & economic association annual meetings. Vanishing Vaccinations: Why are so many Americans opting out of vaccinating their children?

Shields, B. M. (2005). The bioarchaeology of tuberculosis: A global view on a reemerging disease. Southeastern Archaeology,24(2), 235-0_4. Retrieved from http://0-search.proquest.com.alice.dvc.edu/docview/207213529?accountid=38376

Wang, S. (2012, February 15). More Doctors 'Fire' Vaccine Refusers. The Wall Street Journal.

Review: Wasted: A Memoir of Anorexia and Bulimia

The need to succeed and to excel in every aspect of their lives leads many women, especially in the upper classes of society, to develop the problem of anorexia or bulimia. The drive for these women to succeed is so great and what is expected of them by both their families and the society tends to affect them negatively as they try to fulfill these expectations. The mothers of these women tend to be perfectionists and are very demanding of their children setting such unreasonable goals for them to achieve that this pressure becomes overwhelming for them. The fathers of these women tend to always be busy and have not enough time to get to know their families better and are often busy. Such situations always lead young women into living a life which is not fulfilling to them and in the process; the void which has not been filled by doing what they would have loved to do is often filled by an obsession with food or the lack of it. These matters are dealt with extensively in this book as Marya Hornbacher tells the story of her personal experience when dealing with eating disorders as well as her road to regaining what can be considered as a normal life.

One of the lessons learnt from this book is the fact that anorexia and bulimia are disorders which are more prevalent in upper class families than in the working class ones. The main reason for this is most likely because of the higher expectations expected from the members of such families and their feeling of inadequacy due to the fact that they are not able to fulfill these expectations. It is therefore necessary for parents to read this book so that they can get a hint of what really goes on with their children and to also ensure that they raise their children in a considerate environment where they do not feel too pressured to succeed. Furthermore, it is imperative that parents pay close attention to their children and talk to them often so that they can gauge their mood and feelings. In this way, the psychological problems which bring about anorexia will be prevented.

Anorexia and bulimia are psychological disorders which affect a large percentage of people in the world today and it is most rampant in the United States. It is necessary for these disorders to be studied as psychological problems and this book is a chronology of experiences related to these problems. This book can be used as a guide on how the people affected by anorexia and bulimia behave as well as how to find ways of curing them from these disorders. I believe that this book is an eye opener in many matters concerning eating disorders and their causes and it can be used in generalized terms to determine how most of the people affected by these disorders can be helped to regain their self esteem. It can be argued that this book is a credible psychological book since it is based on the real life experiences of somebody who was affected by these psychological disorders and managed to pull herself out of these problems and make something out of herself. It is for this very reason that this book should be considered as a psychological book.

Reference

Hornbacher, M. (1999). Wasted: A Memoir of Anorexia and Bulimia. New York: Harper Perennial.