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The Ethical Neutrality of Prospective Payments: Justice Issues

Published online by Cambridge University Press:  29 July 2009

Jean McDowell
Jean McDowell
Affiliation:
RNFNP, has a Master's in Philosophy and is currently writing her dissertation in the Philosophy Department at Loyola University of Chicago. She teaches and consults in the area of healthcare ethics.
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Extract

The U.S. healthcare system has been subject to unprecedented scrutiny over the past three years; one of the results of this scrutiny has been recognition of the serious problems that exist in both healthcare delivery and reimbursement mechanisms. While the verbal debate in Washington has essentially ceased, within the healthcare community a historic shift has taken place in the way healthcare reimbursement is structured: increasingly, traditional fee-for-service reimbursement methods are being replaced with capitation reimbursement methods. While this phenomenon originated on the West Coast, it has spread to all geographic sectors of the United States in varying degrees and can be expected to dominate the funding patterns of healthcare over the next decade.

Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 5 , Issue 4 , Fall 1996 , pp. 570 - 578
Copyright
Copyright © Cambridge University Press 1996

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References

Notes

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11. See note 10. Pellegrino, , Thomasma, 1991:123.Google Scholar

12. I do not address the issue of physician incentives for ‘efficient care’ since that poses obvious and, seemingly unavoidable, conflict of interest issues. While important to the discussion, that issue is best taken up within the context of the implications of prospective payment funding for the physician-patient relationship.

13. Callahan, D. What Kind of Life. New York: Simon and Schuster, 1990.Google Scholar

14. A hospital administrator echoed this when he commented that “the room rate is meaningless because no one pays the entire rate anyway. It really doesn't matter what we set our rates at, the insurer is only going to pay a set portion of that rate and neither Medicare nor Medicaid is going to pay the whole bill anyway.”

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16. See note 15. Gauthier, 1988:113.Google Scholar

17. See note 15. Gauthier, 1988:118.Google Scholar