Response Knightes



 Weighing the alternatives is an important part of problem solving. This is where we  examine whether a solution is achievable based on resources available and social acceptability we must consider unintended consequences or new problems the solution may cause.  


One situation that I personally have had to deal with is involved with hospitals and healthcare.  Let us be frank for one moment and understand that the purpose for any business is to make money.  Yes hospitals are businesses and those who deal with the business portion of the hospital are the stakeholders.  Most of these individuals are investors who give money to the hospitals so they can make money.

Last year, January 2018, my mother who has had heart problems most of her life found out her heart was failing.  She had a pacemaker and she had an old valve that needed to be replaced.  I was part of the discussion with the doctor on what her options were.  She has had good healthcare most of her life.  The school system that she worked for had their own healthcare policy that paid for her previous two surgeries which saved her life.  

The options that she was given were on the opposite ends of the pay scale so to speak.  On the one hand, she could have had her valve replaced with a flesh valve or a mechanical valve; both were options we were able to consider.  On the other hand, she could have had a brand new heart but her healthcare refused to pay for this because of her age.  I am a realist and I understand that the likelihood of her qualifying for a new heart compared to a younger person was slim so we decided to go for the flesh valve.  During her surgery, the flesh valve did not work correctly so they had to put her on bypass and then try the mechanical valve.  Placing her on bypass was stressful to her heart but they had to do it multiple times because as they were operating on her heart, they kept finding other issues which caused massive internal bleeding.  I was the one to make the decision to let her in peace because after 4 separate times, they could not stop the bleeding.  

Now I did not discuss this to make a sob story, but to highlight the business part of the hospital.  Yes my mom who has paid into her healthcare for 50 years deserved this new heart, she paid her fare share but the days of community hospitals are over, with most of them having business mindsets (White, 2018).  Sometimes they focus on hearts, cancer, even children, which brings about experts who have perfect records with their practice.  I knew she would not have made it but luckily her healthcare had a clause that they had to at least try.  

After she had passed, I found out the same hospital replaced an even older person's heart with a younger heart.  Now I do not know if it would have even mattered because finding a match can be difficult.  The upsetting part was this person had lots of money and paid to have this surgery.  The person's medical insurance did not pay for anything; this person paid out of pocket.  Of course the hospital would do this.  Surgeries are expensive and depending on who is paying the bill, those people who pay for themselves or have better health coverages tend to get priorities.  Of course ethics comes into play but hospitals are there to make money.  If they conducted their businesses ethically, they would lose money, lose their investors, lose their good doctors because they could not pay them.  Of course my Mom's doc was decent but he was not the best.

So giving my Mom the chance to have a new heart was the obvious solution since surgery was very risky and her chances of survival were not good to begin with.  She most probably would have survived had she had her heart replaced but since she did not have money, the only option was the risky surgery but this would have never happened if she did not have good insurance.

This of course is a problem throughout the United States regarding healthcare.  If she had not done the surgery, she would have passed away and it would have been miserable.  Lucky for her, she was asleep when she passed.  Finding out months later about another person buying a heart to survive was very upsetting but the realist in me understands.  The son who lost his mother did not agree.  These decisions happen with hospitals and medical centers almost every day, with many families who cannot afford good healthcare missing out on lifesaving solutions.  But the fact of the matter is, hospitals rarely will ever do anything for free.  Someone must pay for this because even an aspirin costs money in a hospital.

The same can be said for other public safety organizations.  Like the military, money is paid but there is no profit.  The safety that the military and public safety organizations provide is the "profit" but hospitals do not make money on ethics or being the good guy.  They make money so their investors will get profit from their investment.  Hospital resources cost money.  Surgeries cost money.  Paying good doctors costs money too.  The business operations of a hospital are never popular to those that are in need of its services.  Andre and Velasquez wrote that for-profit hospitals that generate money will have greater access to state of the art equipment, which can end up generating more money (Andre & Velasquez, 2015).  Some profit hospitals will even refuse patients if they are unable to pay for their medical care.  Ethically this is wrong however for-profit hospitals are not obligated to provide medical care to poor people and/or people without access to health care.  Even if they do have healthcare, there are procedures that are not always covered because even healthcare companies are there to make money too.


Andre, C. & Velasquez, M.  (2015, November 16).  A healthy bottom line: Profits or People?  Retrieved from SCU.EDU:

White, Martha C.  (2018, February 7).  Hospitals made $21B on Wall Street last year, but are patients seeing those profits?  Retrieved from NBC News:

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