The Morality of Managed Care Essay

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The Morality of Managed Care

"The preservation of health is a duty" according to Herbert Spencer, an English philosopher (Andrews, 1993). Managed care conglomerates provide health coverage for increasing numbers of Americans. Many critics question whether these businesses provide care dutifully. At the very least, the present managed care system requires health care providers and recipients to reexamine established principles underling physician-patient interaction. Although health maintenance organizations are commonly misunderstood, Americans hope these institutions will dampen runaway health care expenditures. Since HMO's are increasing in number, health care recipients need to examine how established, ethical principles in America
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Unlike fee-for-service reimbursement which was normative previous to managed care, HMO's usually pay doctors and hospitals massive sums up front. These payments are arranged per diem, by capitation, or sometimes by fixed salary. Many critics of managed care believe that these compensation packages are immoral.

What Health Care Is Now

In order to ascertain the merit of managed health care, ethical presuppositions guiding our health care system require consideration. In the United States, four main principles undergird the way health care is practiced. These principles are: beneficence, nommaleficence, autonomy and justice. Beneficence is the obligation of health care providers to render help to people in need. Just as health care workers are called to provide care, they also have a duty to do no harm. This principle is commonly called nonmaleficence. At times, the possibility of doing good may result in injury. Therefore, the principle of beneficence and nonmaleficence do not always concur. Thirdly, the principle of autonomy allows patients to make choices regarding their health care. In other words, health care providers should allow patients to make the final decision regarding their treatment plan. Finally, justice refers to the ethical concept of treating everyone in a

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