Walking the HMO balance.
Fidelity is the ethical obligation to act in good faith to keep promises, fulfill agreements, and maintain relationships and fiduciary responsibilities. Consumers are increasingly interested in the balance between the fiscal viability of our current healthcare delivery system and the system's reason for existence--that is, to serve the health needs of clients. Escalating healthcare costs have driven many institutions and third party payors to examine service and payment practices. Some consumers and consumer rights groups contend that these evolving practices threaten the very essence of health and healthcare. The ethical obligation of fidelity, especially as it relates to the business model of healthcare, is examined. Threats to fidelity are reviewed, and the response to these threats by one consumer rights group is presented. A case study is included.
Gallagher
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D000328:Adult; D002140:California; D016265:Conflict of Interest; D004992:Ethics, Medical; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D019458:Insurance Coverage; D012017:Referral and Consultation; D009626:Terminology as Topic; D014481:United States; D014945:Wound Healing