Incentivizing Patient Choices: The Ethics of Inclusive Shared Savings

Bioethics 30 (6):597-600 (2016)

Richard Y. Chappell
University of Miami
Is it ethical to pay patients for selecting cheaper medical treatments? The healthcare system in the United States is notoriously profligate, at least in part because when insurers foot the bill, patients have little incentive to avoid wasteful treatments. One familiar means for dealing with this problem is for insurers to offer reduced co-pays to patients who select cheaper treatments. Would it be ethical to take this one step further, beyond the zero bound, sharing the savings of cheaper treatments by positively paying the patients who select them? Schmidt & Emanuel recently proposed this policy of ‘Inclusive Shared Savings’. This article examines various ethical objections to the idea.
Keywords inclusive shared savings  medical ethics
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DOI 10.1111/bioe.12267
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