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Essay on Assessment of an Ethics Committee
Market competition and the rise of managed care are transforming the healthcare system from a physician-dominated cottage industry into a manager-dominated corporate enterprise. The managed care revolution is also undermining the safeguards offered by medical ethics and raising serious public concerns. These trends highlight the growing importance of ethical standards for managers. The most comprehensive ethical guidance for health service managers is contained in the Columbus Regional Hospital's Ethics Committee Code. An analysis of the Code suggests that it does not adequately address several ethical concerns associated with managed care. The Columbus Regional Hospital's Ethics Committee may wish to develop a supplemental statement regarding ethical issues in managed care.
A supplemental statement that provides more specific guidance in the areas of financial incentives to reduce utilization, social mission, consumer/patient information, and the health service manager's responsibility to patients could be extremely valuable in today's complex and rapidly changing environment. More specific ethical guidelines would not ensure individual or organizational compliance. However, they would provide professional standards that could guide decision making and help managers evaluate performance in managed care settings.
Among the many challenges posed by the rise of managed care are serious and growing concerns about the ethical environment of healthcare. Under fee-for-service payment the most serious ethical problems involved the provision of medically unnecessary care. Most forms of managed care reduce or eliminate incentives for overtreatment and many managed care plans pursue laudable goals, such as preventing disease and providing healthcare as efficiently as possible. However, some managed care organizations (MCO) have introduced strong financial and administrative incentives to limit the use of medical services and have undermined the ability of physicians to serve as agents and advocates for their patients. The managed care industry is diverse, and the more serious ethical concerns tend to be linked to.......
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