I have mixed feelings about this question. a On the one hand, I'm
saying no, the government should not be in a central position, but I
also feel like someone needs to be in a central position to issue
physician practice guidelines based on cost efficiency. When the
government gets involved, things always go wrong, and it becomes
solely about money. In healthcare, physicians already have to answer
to the insurance company any time they order a test or prescribe
medication. And it's not because the insurance company is so
concerned about the patient. They don't want to pay for the MRI that
costs $1500 but would rather pay for the $800 CT scan. a
I believe physicians should be able to treat their patients with
treatment that will give the best outcome, not what's going to be the
cheapest. If guidelines are going to be put in place, they should be
done with the patients' best interests at the forefront. For example,
the US Preventive Services Task Force and the American Cancer
Society have issued guidelines incorporating cost-effectiveness data
that recommend that physicians reduce the frequency of screening
low-risk women for cervical cancer (Hummel & Ubel, 2004). In
response to these recommendations, many physicians have actually
reduced their screening rates (Hummel & Ubel, 2004). The
government can be in a central position to issue guidelines, but it's all
about how they go about doing it. The patient's needs must be at the
forefront. Guidelines can act as a socially sanctioned standard of care,
a signal to clinicians that their pursuit of benefits for individual
patients needs to be limited by cost-effectiveness concerns (Hummel
& Ubel, 2004).
References
Hummel, E. K., & Ubel, P. A. (2004, December). Cost and Clinical
Practice Guidelines: Can Two Wrongs Make It Right? AMA Journal of
Ethics. Retrieved May 6, 2022, from https://journalofethics.ama-
assn.org/article/cost-and-clinical-practice-guidelines-can-two-
wrongs-make-it-right/2004-12
