Fee for Service Care Versus Managed Care Essay

Words: 2295
Pages: 10

Some researchers feel that our society has unrealistically demanded the health care system to maximize quality while lowering the costs of health care services. That if we demand this change, there is no way we are realistically considering the cost of health care. I understand that everyone wants to receive the best therapy without paying a large amount of money. When you think about this idea, this plan would take time to execute. One of the cons of living in a country like the United States is that we citizens expect to have things right when we want them. I totally agree that we deserve the best services at the lowest prices. But how should we go about executing this plan? We will have to balance the plan between two approaches, the …show more content…
The insurance company had no decision-making control over the providers, and there is no ability for unified decision making. The differences of the conflict between quality and cost are split: Physicians have income incentives to maximize the services they deliver to patients, while administrators have market incentives to keep premiums low (Eddy, 1997). Characteristics of managed care that affect the cost/quality trade-off include the following: The managed care organization has responsibility for the health of a defined population: all of the people who paid dues. For this “defined population”, the MCO is responsible for the entire spectrum of care, ranging from primary prevention to screening, diagnosis, treatment, rehabilitation, and support care. The contacts are initiated not only by the patients, but by the organization. Physicians are not left alone to practice as they see fit. The MCO has a variety of clinical management systems for managing the actions of physicians. The MCO has a capacity for centralized decision making. The medical director feels the pressures both to improve quality and to reduce costs (Eddy, 1997). There are ethical principles in almost everything we do. Some of the ethical principles that apply to tradeoffs between cost and quality include fairness, equality, and optimality. In terms of fairness, if a group of people are making the same input to a pool of resources from which the costs of treatment will be made, they