The Harris County Coal Company operates 10 small mines in West Virginia with an average of 30 miners each. Congress is considering revising the Affordable Care Act to create single-payer, national health insurance program. It would provide government-financed health care for all with a provision that the insured pay the first $50 in any given year. Within the past year, scientists have developed a number of techniques to minimize the effect of coal dust on miners, who develop black lung disease from prolonged exposure. The problem is that the most effective prevention techniques are expensive. They required both massive ventilation systems and also costly hourly monitoring of the air quality throughout the mine. Analysts estimated the full prevention program would cost $7,500 per miner. The mine workers' union demanded that the company initiate the program, but recognized that small-scale mines, such as those run by Harris, were marginal operations. The added cost, according to management, would close the mines. By coincidence, a government study has just shown that the predicted cost to the government for treatment of black lung disease from the mine under present conditions would also be about $7,500 per person, prorated over all miners.

The government raised several serious policy questions. Should it require the mine to install the black lung disease prevention program to protect the miners and to promote the public interest by lowering the cost of national health insurance? Should the government allow the mining companies to pass the cost along in the form of a pay cut or higher prices?

The mine management proposed another plan, giving the miners a choice between working in the mines with the prevention program installed and taking a pay cut and working in the mines in their present condition without taking the pay cut. Without the prevention program, the national health insurance program would not cover those working in the mines if they developed black lung disease.

Questions to Consider

1. Which option would you recommend?
2. What are your reasons?
3. How would you apply the principles that guided your decision to other policy issues?
4. What would be the implications of applying these principles more broadly?

Answer rating: 100% (QA)

Given the complex ethical and practical considerations involved heres my recommendation 1 Government Mandate for Prevention Program I would recommend ... View the full answer