Ethical Issues In Managed Care

The training will includes healthcare codes of ethics for managed care and five ways to improve ethics in the managed care organization.

Ethics are a set of moral principles that serve as a guiding philosophy for behavior. Consequently it is not a surprise that ethical dilemmas occur daily in the health care setting. Any nurse who refuses to provide care for a patient faces an ethical dilemma (Kuhn, 2012, pp. 412-418). The reasons given for refusal range anywhere from a conflict of personal values to fear of personal risk of injury. Nurses do have the right, at times, to refuse patient care assignments. The decision to accept or reject an assignment must be based upon a judgment by the nurse of the nurse 's ability to provide competent patient care. This paper aims to show both sides of the argument when it comes to nurses refusing a patient assignment. One side believes that nurses has the right to refuse patient assignment, as they must be true to themselves if they want to perform their best on the job. On the other hand, the other side believes that it is the nurse’s responsibility to care for all patients and, therefore nurses cannot simply refuse a patient.

This paper will discuss the different effects managed care has on the quality of mental health care for its clients. On the positive, managed care has increased availability to a cliental that would otherwise not be able to afford mental health care. On the negative, there has been a reduction in quality in order for managed care corporations to keep costs low and still make money. Proper implementation of managed mental health care would likely result in high quality, low cost mental health care.

What do you think will be the next ethical issues created by healthcare reform? What areas of current healthcare reform have yet to be resolved?

Healthcare management usually involves a wide range of activities. It in loves planning, administration, regulations and legislation all aimed at enhancing the quality of the system for the benefit of the patient and the medics. Planning is important as it provides efficient health care to all who are seeking medical intervention. However, planning should not be used as an intimidating tool denying the individual his or healthcare unless such intervention is necessary to the public health interest (Brody 2010). This has been none of the ethical issues surrounding the healthcare system. There has been a debate on what entails patient autonomy and the extent to which the healthcare team should participate in decision

While visiting my mother in the hospital this past weekend, I was a witness to an event that was quite unsettling. A homeless gentleman, who looked to be about 35 years old, was asked to pay $150 upfront for medical services due to his lack of insurance. The man informed the medical assistant that he was homeless and did not have the funds, to which the assistant responded that no services would be rendered without pay and turned the man away. The man stated that he was experiencing continuous chest pains, which could be an early symptom of a more serious condition. However due to his lack of funds and the fact that he was uninsured he was not permitted to be seen by the doctor.

The ethical dilemma I encountered at my placement involves a male in his late-sixties, who has recently suffered a stroke. Mr. A’s situation is unique as he has been unable to speak and his cognitive abilities have declined since. The Fraser Health agency protocol is to contact the patient’s family to determine who would be the temporary substitute decision makers (“Information for temporary substitute,” 2015). The health care consent and care facility admission act describes how decisions are to be made if a patient is determined incapable (Nidus Personal Planning Resource Centre, 2012). The next steps required liaising with the home health team in the community to determine if Mr. A had ever listed any family members as his emergency contacts.

Do health care workers have the right to conscientiously object to providing care if it varies from their own personal moral and ethical belief system?

This scenario involves multiple ethical issue that is very difficult to be addressed by the health care providers. Since our ultimate goal is to provide optimal care to the patient. Moreover, we care about the entire family dynamic and wellbeing at the same time. I believe it is critical for health care provider to provide a balance between the mother wishes and prioritize the patient best interest by preventing unnecessary harmful procedures. I believe the compromise solution that was reach by the health care provider and the family to have an early Christmas was a great mutual goal. It will facilitate the family coping process and at the same time preserve the patient dignity and comfort.

Community-based services are long-term healthcare provided outside of institutions and are offered in a community environment and/or patient’s home. This encourages a sense of independence while provide the comfort of familiarity for the patient.

“Healthcare professional faces complex ethical dilemmas in the workplace.” (Murray, 2010). There is an expectation that a professional working in a healthcare field demonstrates the highest degree of moral character. A morally courteous person stands up for right things even if it means to do alone. The final goal of demonstrating moral character is to protect ethical value and put ethical principles into action. There are various moral characters which I would like to see in the employees. I would like to see a healthcare professional having characteristics such as professionalism, honesty, kindness and commitment (towards their patient). For a professional working in an acute care facility, demonstrating a high level of all the above four

29. In your opinion what responsibilities, if any, does a physician or other health care practitioner have toward difficult family members or other third parties who interfere with a patient’s medical care?

Although health care in the United States is considered to be one of the top ranking medical services, it is however becoming inadequate due to one fatal flaw: money (Vaughn 692). It is well known that a person admitted to the hospital, also admits their wallet, as the costs of certain procedures can be quite draining. However this is reality. There is no such thing as a health care system which “can provide maximum healthcare for everyone” (Vaughn 681). Therefore doctors must decide what is ethical and what is immoral when “costs restrict how much health care can be delivered” (Vaughn 681), to certain patients. This is the question in which Dr. Oz must ask himself as he is informed that his patient cannot afford a particular treatment; a

Patients receiving integrated medicine for their health care needs should feel that they are not a burden. it is ethical to make sure that the patient safety is observed during transport for additional services. Making sure that patient privacy and confidentiality is protected from unauthorized use or view. Perhaps the most important would be informed consent, the patient is aware of procedures necessary and that the patient has signed the authorization. "While your professional staff might not agree with what your patients do, they will still expect you to honor their autonomy and to make sure accurate diagnosis of their condition Morrison, 2011)."

Managed care is simply a system that delivers health care to a specific population purchased though health insurance plans. It is an approach to financing and delivering health care that seeks to control costs and ensure or improve quality of care through a variety of methods, including provider network management, utilization management, and quality assurance. Patients agree to visit only certain doctors and hospitals, which a managing company monitors the cost of the treatment. Managed care has been introduced as a way to bring equality for health care utilization by ensuring those receiving the treatment actually need it, based on their symptoms and seriousness of injury. The managed care industry has made undeniable impacts in nearly every aspect of the health-care industry. Mental healthcare workers have endured drastic changes in their clinical practice. George H. Northrup a physician in mental health, talks about the uprising crisis in mental health care and how it has to do with money. In past years psychologists set fees based on their training and experience, and health insurance companies typically reimbursed patients a portion of that amount. But mental health benefits are now “managed” patients may be restricted to doctors in the insurance company’s network, and doctors who want to be in the network must accept drastically reduced fees. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on