The case against persuasive advertising by health maintenance organizations

Article Abstract:

Advertising by health maintenance organizations (HMOs) has not been criticized as has advertising by private physicians, but it may be harmful for several reasons. Advertising by HMOs may not help consumers because it does not increase treatment options. It may encourage individuals to keep switching health care plans, which disrupts physician-patient relationships and continuity of care. Consumers may have unrealistic expectations as the result of HMO advertising. Advertising by HMOs may commercialize medicine, which has traditionally been more of a reflection of deeply held social values. It also increases administrative expenses of health care. Despite these issues, the Federal Trade Commission is unlikely to ban advertising by HMOs. Legislation could be passed to limit advertising by HMOs to informational rather than persuasive approaches, but this would be difficult to enforce. The best solution may be for HMOs to limit advertising to public interest statements.

Social aspects, Advertising, Recruiting, Hospital patients, Health maintenance organizations

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The problem with futility

Article Abstract:

Futility in medical treatment dates back to the time of Hippocrates. Some patients and family members may insist on life-sustaining treatment that their doctor may think is futile. Most of the controversy surrounding this issue concerns treatment of patients in a chronic vegetative state, use of CPR to resuscitate terminal patients and use of technology to carry out the function of vital organs. Futility should be defined in terms of the goals of treatment. The wide range of values held by different members of society make it difficult to define which types of treatment are futile. The outcome of different types of treatment is always uncertain. But a statistical cutoff point could be established to limit the use of treatments that may be futile. Treatment that is considered futile could be limited to curtail the cost of treatment, but this type of policy may be difficult to instate. Futility may not be a useful concept for limiting treatment of terminal patients.

Ethical aspects, Terminology, Medical ethics, Critical care medicine

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New guidelines for coding physicians' services - a step backward. (Sounding Board)

Article Abstract:

Guidelines proposed by the Health Care Financing Administration in 1998 are complex, probably unnecessary, and will not fairly compensate physicians while eliminating Medicare fraud. The guidelines require physicians to consult many different charts to determine how to code Medicare patient visits. The codes determine how much the physician will be paid for treating the patient. However, the guidelines that existed before 1992 were much simpler and probably served well enough. Other solutions include billing physicians for the time they spend with patients or paying them a salary.

Innovations, Compensation and benefits, Physicians, Medical professions, Science and technology policy, United States. Centers for Medicare and Medicaid Services, Relative value scale payment systems (Medical care)

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