Exam Discussion | Healthcare--Ethics of managed care

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Healthcare--Ethics of managed care

Posted by: Bruce Lawrey on October 12, 2009 at 3:06PM EST

This is more of an observation than question, however the ethics involved in managed care seems quite complicated. Throughout the presentation the discussion was that, the Provider was only interested in helping to keep patients well enough until they could be passed on to another responsible party, which may be Medicare or another HSO. This is the first time I heard that physicians or LIPs have to sign “gag” orders in some circumstances. How can this be ethical? Does anyone have more information to share related to “gag” orders?

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(6) Comments

Posted by: José Acosta on October 12, 2009 10:20PM EST

I don't know much about the "gag" orders but HMOs received a black eye in the '80 and '90s because the failed to deliver on their promises. The organizations were designed to yield substantial savings as much as 30-40% compared to fee-for-service. The idea was to control costs at whatever the cost. For the healthy patient requiring minimal services the HMOs worked out great . The problems began when you had patients with multiple comorbidities requiring extended care. I suspect that most HMOs tried their best and provided exceptional care. A few outliers became the poster child for greed and were vilified by the public.

Posted by: Diane Bergman on October 13, 2009 12:50PM EST

I am currently involved in the managed care field. And, as to the extent of my knowledge, it is illegal to have gag orders in any contract with a provider. And, personally, if I was a provider, I would raise all kind of heck with the state regulatory agency if that laguage was/is still showing up in contracts.

Posted by: Edith Ego-Osuala on October 14, 2009 11:50PM EST

When HMO was first introduced in the 80's, HMO contracts had "gag orders" but it was received very badly. Physicians protested and it received a very bad publicity and in turn it became illegal to have a gag clause in any contract. I agree with Diane, it is now illegal. I do not know if there is a law to this effect but that clause no longer shows up in any HMO contract.

Posted by: Debra Hodges on October 16, 2009 10:47PM EST

Thank you for the discussion. This is definitely not my area of specialty so it was very informative. Have a nice evening!

Posted by: Lora Cochran on November 8, 2009 3:03PM EST

Very Interesting dialog.