Incentives and obligations under prospective payment

Journal of Medicine and Philosophy 12 (2):123-144 (1987)
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Abstract

In this paper I analyze the alleged conflict between economic incentives to efficiently utilize health care resources and the obligation to provide patients with the best possible medical care. My analysis is developed in four stages. First, I discuss briefly the nature of prospective payment systems and economic incentives as well as the issue of professional autonomy. Second, I disscuss the notion of an incentive for action both as an economic incentive and as a concept of moral psychology. Third, I analyze several definitions of the physician's professional obligation and discuss four conditions that morally qualify the obligation. And fourth, I explore why the views of economists and physicians differ so strikingly on the question of economic incentives. In the process of this analysis, I argue that criticisms of prospective payment systems which are premised primarily on the conflict between economic incentives to contain cost and the professional obligation of beneficence are probably as much a matter of rhetoric as serious argumentation. Keywords: autonomy, beneficence, cost containment, economic incentives, moral obligation, prospective payment CiteULike Connotea Del.icio.us What's this?

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George Agich
Bowling Green State University

Citations of this work

Rationing and Professional Autonomy.George J. Agich - 1990 - Journal of Law, Medicine and Ethics 18 (1-2):77-84.
Conflicts of Interest and Management in Managed Care.George J. Agich & Heidi Forster - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (2):189-204.
Rationing and Professional Autonomy.George J. Agich - 1990 - Journal of Law, Medicine and Ethics 18 (1-2):77-84.

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