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Biomedical subjects

E H Morreim

Publications and source records attributed to E H Morreim.

At least 19 recordsLinked to original sources
PubMed1997

Managed care, ethics, and academic health centers: maximizing potential, minimizing drawbacks.

As academic health centers (AHCs) enter into various forms of managed care, they face a number of managed care's well-known ethical issues: utilization controls and loss of clinical autonomy; incentives and conflicts of interest; strained collegial relations; and questionable origin and validity of practice guidelines. Also, special issues arise regarding teaching relationships, faculty structure, and standards of care. Although the ethical hazards of current forms of managed care are quite pervasive and arise largely through short-sighted cost controls, emerging forms of integration and payer-level capitation permit considerably greater flexibility to provide care that is coherent, comprehensive, even creative. AHCs, as integrated multispecialty group practices, may be in a surprisingly good position to explore the best possibilities of global capitation while minimizing the ethical drawbacks of current forms of managed care.

Academic Medical Centers↗
PubMed1997

To tell the truth: disclosing the incentives and limits of managed care.

As managed care becomes more prevalent in the United States, concerns have arisen over the business practices of managed care companies. A particular concern is whether patients should be made aware of the financial incentives and treatment limits of their healthcare plan. At present, managed care organizations are not legally required to make such disclosures. However, such disclosures would be advisable for reasons of ethical fidelity, contractual clarity, and practical prudence. Physicians themselves may also have a fiduciary responsibility to discuss incentives and limits with their patients. Once the decision to disclose has been made, the managed care organization must draft a document that explains, clearly and honestly, limits of care in the plan and physician incentives that might restrict the care a patient receives.

Conflict of Interest↗
PubMed1994

Of rescue and responsibility: learning to live with limits.

Universal access to health care is still a dream rather than a reality in the United States. This is partly because a rule of rescue, by impelling us to help people in need, urges us to ignore the limits of our health care policies wherever those limits would adversely affect a given individual. As the rule of rescue undermines whatever limits we set on health care entitlements, it can thwart the cost containment so essential to expanding access. Rather than accept unlimited expense, we have thus far declined to universalize health care. The situation is exacerbated by an economic insulation shielding patients and physicians from the costs of care, prompting both to regard health care as free, an unlimited right. To reverse this costly entitlement mentality and place reasonable limits on rescue, patients must exercise greater personal responsibility for the costs of their care by directly experiencing some of the economic consequences of their health care decisions. Several mechanisms are available to accomplish this goal without posing economic barriers to needed care or penalizing people for becoming ill.

Federal Government↗