title: Incentivizing Patient Choices: The Ethics of Inclusive Shared Savings.
abstract: 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' (ISS). This article examines various ethical objections to the idea.
authors.affiliation: r.chappell@gmail.com.
authors.forename: Richard Yetter
authors.identifier: 0000-0003-3322-4935
authors.initials: RY
authors.lastname: Chappell
mesh_terms: D002755:Choice Behavior; D017046:Cost Savings; D004992:Ethics, Medical; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D009042:Motivation; D010361:Patients / Q000523:psychology*; D014481:United States
keywords: inclusive shared savings; medical ethics