Ethical Issues In Managed Care

This question represents at least half of the medical community, and makes people question the intended and unintended consequences in a profit - driven health care system, the supposition of quality health today, and whether they

Over the last few decades, managed health care has revolutionized the way medicaid beneficiaries treat essential healthcare services such as family planning and parenthood programs. The term managed care is a health insurance plan or system that allocates the provisions, quality and cost of caring for an individual. It has an significant role when it comes to providing health care services to medicaid members and the ways it’s utilized. Managed care plans create contracts with health care providers and medical institutions that help provide services at a lower and more affordable cost to their members. Additionally, managed care plans tend to pay health care providers directly so that it’s members don’t have to pay out of pocket for services

First, the ACA has brought about considerable improvements in access to affordable health insurance in the United States. On the basis of their own reports, newly insured Americans are also able to see physicians within reasonable periods of time, and anecdotal reports about restricted access to out-of-network providers, although a concern, have not yet caused a major backlash. Second, the implementation of the ACA has coincided with another important development — a slowdown in the rate of increase in national health care spending. From 2010 through 2013, per capita U.S. health care expenditures increased at the historically low rate of 3.2% annually, as compared with 5.6% annually over the previous 10 years. As a percentage of the gross domestic product, health spending has stabilized at approximately 17%.

Preventive care and early intervention is the emphasis of managed care. “Many critics believe that the managed care organizations will not continue in their current state.” The quality of services needs to take precedence over cost and efficiency to improve

It increases the demand for the services and word spreads of the physicians (Peloso,

The Act has effectively decreased the quality of health care as a result of its compensatory cuts to medical professionals; decreasing funding will undoubtedly destroy the quality of medical practices. Fox New’s Ali Meyer conducted a survey of medical professionals in which half agreed the Affordable Care Act has a negative impact on the medical profession, including reduced quality of

In the UK, policies for health, safety and security are not only give positive impact it also creates dilemma in relation to implement. Dilemma refers to a situation in which a difficult choice has to he made between two or more alternatives, especially equally undesirable ones. There are different types of dilemma in safety. This includes * Resource implications

For a majority of enrollees with lower incomes, the federal subsidies make the premiums more affordable. For those even closer to the poverty line, they can receive additional subsidies that reduce the deductibles even more. But for many middle class families that earn an average income of $97,000 for a family of four, the health coverage premiums and deductibles have sky-rocketed (Luhby). This is causing a huge amount of Americans opting to stay uninsured, rather than spend thousands a year. According to a Kaiser study, 46% of uninsured adults tried to get coverage but did not because it was too expensive (Luhby, 2017).

In the film Escape Fire the Fight to Rescue American Healthcare, there were many insightful examples of why our Unites States healthcare revolves around paying more and getting less. The system is designed to treat diseases rather than preventing them and promoting wellness. In our healthcare industry, there are many different contributors that provide and make up our system. These intermediaries include suppliers, manufacturers, consumers, patients, providers, policy and regulations. All these members have a key role in the functionality of the health care industry; however, each role has its positives and negatives.

They must ensure that they are providing adequate services to patients and at the same time ensuring that insurance companies are getting paid (Saint Joseph’s University, 2011, Para 6). Along with that they must secure that they are getting paid. Furthermore, physician moral and ethics are challenged as well; Thus, causing them to rethink how they take on their responsibilities as a medical care provider by trying to keep patients best interest, insurance companies interest and their own interests. This conflict with trying to meet the needs of several different stakeholders causes strain on the physician because they must walk fine line to please each. While trying to please a specific stakeholder another holder could be compromised.

This example was used to demonstrate the multiple difficulties that patients encounter while seeking care in a health care system that should be working to keep patients healthy. The Institute of Medicine emphasizes, that despite the six concerns listed previously being regarded as important and valuable, the American health system has continuously failed at meeting those goals despite the amount of money received and the work done by health

Under direct contracting, providers must go beyond their traditional roles as suppliers of care to owners of integrated financing and delivery systems. This transition can be difficult for employers to compile and manage actuarial and legal mandates. A physician group can be presented as a threat to health plans, as it does business by obtaining an insurance license. This is because the subcontractor is a competitor. Providers must become active managed care partners with employers, instead of being reactive adversaries of managed care organizations on a contractual basis.

The author really did not mention any positive examples of American medical insurance system’s work. It creates a feeling of prejudice as the system should have positive results to exist for so many years. However, Moore gave enough examples to show there are severe problems in the American medical insurance. Mentions of numbers, historical recordings and people, who decided to share personal experience, support author’s

Great post Brian! The United States moves toward a Nationwide Health Information Network that will allow health care providers to share the patient medical information through electronic medical record whenever and wherever patients present for care. Electronic health records may show beneficence because they are supposed to increase access to health care, improve the quality of care, and decrease health care costs. Although these several benefits of electronic medical record, these benefits may create conflict among several ethical principles (Layman, 2008).

Module: Ethics and integrity for health professionals Name: Alumai John Bosco Reg No: 2016-MPH-RL-AUG-015 Submission date: Assignment 1 (Revised) Instructions: • Answer both questions. • The word limit including references is 1000 words • Proper and complete referencing is expected for both questions.