Ethics vs. Health Care Reform Conflicts


Diverse reforms and those that involve socially significant areas of life in particular frequently result in conflicts during their implementation. Health care reform in the United States, also known as the Affordable Care Act, brought in conflicts with an ethical background in addition to positive changes. This paper analyzes conflicts that arise between ethics and health care reform that appear upon the execution of the Affordable Care Act as well as nurse role in negotiating such conflicts.

Reform in the health care system has many implications for the future of society as a whole and its health in particular. One of the ethical issues related to the reform that leads to conflicts is the legal justification of the right to healthcare (Morden, 2017). One of the justifications for the reform is the discrepancy in access to healthcare due to such reasons as racial background or income of an individual or a family.

The Affordable Care Act that was passed in 2010 implies the provision of access to healthcare for the population, including the elderly and the poor individuals who are usually underserved. On the whole, conflicts that involve ethical issues in health care are usually related to ethical principles of autonomy, non-maleficence, beneficence, and justice (Morden, 2017). These principles appear in diverse clinical issues and cause conflicts, both ethical and legal.

Another ethical problem that leads to conflicts around the health care reform is the one related to health coverage expansion. The idea of the Affordable Care Act is to provide access to high-quality care to all population groups. Still, health care as a governmental sector cannot cover all the citizens because the network of facilities needs further development. In the United States, this problem is partially resolved due to the large private health care industry (Field, 2015). The conflict involving ethical concerns develops because private providers serve more clients than government-run agencies and programs and tend to avoid clients whose treatment can be potentially costly (Field, 2015).

Finally, the utilization of the Affordable Care Act was expected to provide affordable access to care for all categories (Sade, 2015). On the one hand, the population will benefit from universal access to health care for a reasonable price. At the same time, affordable plans for low-income individuals will lead to higher costs of insurance and care plans for the rest of the population, which raises the issue of equality and ethics.

Nurses as Negotiators of Conflicts

The role of a nurse in resolving conflicts that develop on the ethical background of the health care reform is as follows. First of all, nurses should follow their instructions and deliver care to every individual who needs it. Moreover, the nurse can act as negotiators in conflict situations and act in a collaborative, accommodating, compromising, or avoiding way. The major task of a nurse as a conflict negotiator is to explain the existing rights that a person has according to their insurance plan. Moreover, nurses can inform patients about the opportunities of health care plans to prevent future conflicts.


On the whole, the Affordable Care Act, as the reform of health care in the United States, is a controversial issue. On the one hand, it has evident benefits and improves access to care for underserved individuals. On the other hand, it gives rise to conflicts related to ethical issues, which need careful consideration and resolution to avoid further conflict development.


Field, R. I. (2015). The ethics of expanding health coverage through the private market. AMA Journal of Ethics, 17(7), 665-671.

Morden, S. (2017). The ethical right to healthcare in the Affordable Care Act. Web.

Sade, R. M. (2015). Health care reform: Ethical foundations, policy, and law. Journal of the American College of Surgeons, 215(2), 286-296.

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NursingBird. "Ethics vs. Health Care Reform Conflicts." August 23, 2021.