Gutmann, Moreno op-ed details ‘ethical mess’ of health care system

“Surely our fellow Americans with life-threatening diseases of all sorts are also worth saving,” they write.

Amy Gutmann and Jonathan Moreno
Penn President Amy Gutmann and PIK Professor Jonathan Moreno

Published on Wednesday in The New York Times, Penn President Amy Gutmann penned an op-ed with Penn Integrates Knowledge Professor Jonathan Moreno about the importance of revising and reinforcing the Affordable Care Act. 

Titled “The Ethical Mess of Our Health Care System,” the duo, who recently wrote a book on the history of bioethics, detail, as an example, the exorbitant cost for mostly taxpayers of guaranteed treatment for Medicare patients with end-stage renal disease.

A broad ethical question arises: Why is renal dialysis worthy of such generous federal funding compared to lifesaving treatments for other deadly diseases?

The Trump administration, the authors note, is now proposing to rein in costs for the so-called “one-disease carve-out,” in ways that won’t undermine care and will be both cost-saving and lifesaving.

But the administration’s plan, Gutmann and Moreno say, “underscores the absurdity of our current health care debate: It would revamp the program using a provision of the ACA. that authorizes the Center for Medicare and Medicaid Innovation to test models of care that work in the private sector and that can enhance service to patients while also reducing costs. This is, of course, the same health care law that Mr. Trump has pledged to dismantle, including by ordering the Justice Department not to defend it in a major challenge heading to the Supreme Court.”

The ACA could help patients by, for instance, reducing the high costs of drugs, copays, and deductibles, the authors note. But instead of calling for a rework, Republicans and now even many Democrats—as seen in the recent Democratic debate—are threatening to dismember the law. 

“That would be a tragic mistake when there is nothing close to a consensus on how to replace it,” Gutmann and Moreno explain.

It’s a worthy, non-utopian goal to reduce the uneven, complicated nature of health care coverage, the authors insist. “By revising and reinforcing the ACA, we can benefit all Americans without threatening any with the loss of hard-fought, lifesaving health coverage.” 

“Surely our fellow Americans with life-threatening diseases of all sorts are also worth saving.”