Healthcare Reform

I am often asked what ethical questions are posed by healthcare reform. Like healthcare reform itself, this is an very complex issue about which confusion abounds. For example, healthcare reform extends healthcare coverage to more individuals. But it does so in part by cutting Medicare. Is this right? Are we financing our social goals on the backs of seniors? Healthcare reform also tries to push the costs of Medicare down through a program called the Medicare Shared Savings Program. I can’t explain the whole thing here but the basic idea is that Medicare rewards you if you drive down the costs for a given patient population while maintaining or improving quality. This sounds like a wonderfully noble idea except that it creates a huge incentive to fudge your self-reported results on quality. If there is one things we have learned throughout the history of Medicare, it is that incentives to fudge the numbers lead to a whole lot of number fudging. So the ethical questions abound while gathering little attention. The whole topic of healthcare reform is so hot politically that no one wants to touch the ethics questions. I also address some of these questions on my blog for ethics and compliance professionals which is ethicswhisperer.com. Recent posts can also be seen on the right side of this page,