In the former approach, tradable goods, money or services are exchanged between buyers and sellers at a rate that is agreeable to all parties. This approach assumes both the buyers and sellers have enough money, services or goods to have their needs met. The latter approach, public provision, is when all is available to those on an as-needed basis.
The Pharmaceutical and Manufacturing Association warns that whenever there is government control of prices it only has a negative impact on those who are in need of being helped: 1) When funding for new medical technology, cures for diseases and research and development are diverted to more lucrative economic areas; 2) Incentives to enter the pharmaceutical industry decline; 3) More restrictions are placed on providers; 4) the quality of medical care suffers and 5) This leads to a rationing of care. Instead, the association says there has to be a healthcare reform that includes such elements as: expansion of Health Maintenance Organizations and Preferred Provider Organizations; more emphasis on preventative measures; requiring of second opinions for surgery; living wills; drug utilization review systems; encouragement of medical innovation; greater research on outcomes of alternative treatments; greater patient education; tort reform; imposition of substantial deductibles or co-payments and voluntary industry measures to limit drug price-increases (Spinello, 2007).
Spinello (2007) instead looks at the concept of the free market as the most ethical approach to drug costs. He raises the questions as to whether pharmaceutical companies are obligated to accommodate the neediest customers when establishing prices in accordance with the principles of justice. or, may they restrict only to those who can pay the full price? Secondly, if price controls are established, will they work in practice to achieve the ends of justices or bring about negative results as the Pharmaceutical and Manufacturing Association has warned? Spinello argues that the principles of distributive justice justify the implementation of price controls. The claim is often made, he states, that such high prices and resulting exorbitant resultant profits are unnecessary. For example, it is known that the price of azidothymide or AZT produced by Burrroughs-Wellcome Company can frequently cost as much as $6,500 a year, which is unattainable for many AIDS victims, especially those with inadequate insurance coverage. Burroughs-Wellcome has continued to give any information on how it came up with this price. It is believed that the company is pricing this drug the same as an expensive cancer therapy. The difficulty is knowing the cost of the product. As Clarence Walter once stated, "No other area of managerial activity is more difficult to depict accurately, assess fairly, and prescribe realistically in terms of morality than the domain of price.
Pharmaceutical companies could easily offer less costly products for numerous drugs on the market notes Spinello (2007). Every business is entitled to a reasonable profit, but is it morally wrong to charge such high prices even when the market is willing to pay that price? Is it ethical to profit at the expense of those who are suffering? Should other viewpoints be considered, such as the concerns of the sick, especially since they have so much at stake? That is, states Spinello, as with many other business decisions, there seems to be a distinct tradeoff between major financial performance vs. human caring and fairness. If companies choose to be attentive and responsible social agents, they must start to develop a broader view of social obligations and responsibility. They need to see people who have a stake in these decisions. This stakeholder model, gives organizations the ability to link strategic decisions such as pricing with social and ethical considerations. By recognizing the rights of the stakeholders, such as employees and consumers, managers will better appreciate all negative and positive consequences of their decisions. In addition, an honest understanding of the stakeholders will make them analyze the economic and human implications of those decisions and become more responsible social agents. Organizations that take this route with the aim of moral and social responsibility will adopt the moral point-of-view, which makes them strongly committed to positively view the distinct interests of others, including the variety of stakeholder groups.
Given the two diverse approaches of the pharmaceutical association and the stakeholder approach, what is the answer? The concern by the drug companies is that price constraints will make the situation even worse than it is now. However, the principles of justice that govern society as much as free enterprise necessitates that economic decisions should be made that support and protect the disadvantaged. Will the pharmaceutical companies ever recognize the morally right decision when weighing the...
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