The HMO Physician's Duty to Cut Costs

Abstract

A case study is presented involving the question of whether cost considerations should enter into the decision about which medication to use to treat a patient with cardiac arrhythmia who is insured by a health maintenance organization (HMO). Veatch examines the moral implications of introducing financial considerations into patient care when a very small, but real, benefit can be purchased at a substantial cost; he concludes that the expensive drug should be eliminated in this case, but that the decision should be made by the HMO members rather than by the patient or physician. Collen maintains that, regardless of the financing arrangement, the physician has some financial incentive--as well as a moral obligation--to consider both the quality and costs of care and to try to strike a good balance that can be justified by the community's standard of practice. (KIE abstract)