response to discussion

Second one

People do not see the tight controls of the managed care as a way of cutting costs for the patient, they see it as a way of the health plan making money by not having to spend a lot on care for the patient. Even many doctors feel that the managed care plans limit their ability to provide the care they feel is necessary for the patient.

The Managed care plans try to control the cost of healthcare by having limited list of providers that a person can see, they also require that patients have a regular pcp that they see and have to see them prior to seeing any specialist, the patient also has to have prior authorization for nonemergency procedures, they also review and control how long a patient can stay in the hospital and expensive treatments (Moin, Scales, & Sinay, 2014).   Because of these tight controls people believe that the HMO’s makes profits a priority over care (Moin, Scales, & Sinay, 2014).     Many people believe that the managed care insist upon the mother leaving the hospital in 24 hours after having given birth and that the doctors time spent with them is decreased due to the managed care (Moin, Scales, & Sinay, 2014).   They believe that managed care makes it difficult to see specialists and that they limit medical services to the patient (Moin, Scales, & Sinay, 2014).   

Doctors and Hospitals also feel that managed care was dominating them which lead to many mergers and affiliations to gain the larger share of the market and have some leverage to negotiate with the managed care plans (Moin, Scales, & Sinay, 2014).   

Directors have “an open-ended duty to maximize the beneficiaries’ wealth,” The Physician has fiduciary duties with respect to specific tasks such as; the duty not to abandon patients, the duty to maintain confidences and to obtain informed consent for treatment (Illingworth, P. (1999). The Fiduciary-based objection to managed care is that it compromises the doctor-patient relationship which may, in turn compromise the quality of care by pitting the physician’s financial interests against the patient’s health interests (Illingworth, P. (1999).

References:

Illingworth, P. (1999). A role for stakeholder ethics in meeting the ethical challenges posed by

 managed-care organizations. HEC Forum, 11(4), 306-22. Retrieved from

 http://search.proquest.com/docview/229305486?accountid=32521

Moin, T., Scales, C., & Sinay, T. (2014). Principles of healthcare quality management: Tools and applications.San Diego, CA: Bridgepoint Education, Inc.