Under the Oregon Health Plan, there has been an increase in the number of individuals who have access to healthcare. It is estimated that as many as 180,000 additional Oregon citizens have qualified for Medicaid coverage under this plan. It also has decreased reliance on emergency services and charity care, and has even been credited with reducing the number of families on welfare. Ethics in managed care Managed care was embraced as a means to provide organized, cost-conscious healthcare with professional accountability. While there are many recognized benefits to this approach, managed care arrangements have dramatically changed some basic ethical assumptions about healthcare.
Healthcare rationing is common within the managed care environment.
In addition, there have been questions about potential conflict of interest when choices involve weighing financial and medical considerations. Components of managed care that present ethical conflicts are shown in the accompanying figure. The advent of managed care has heightened the awareness that physicians and plan administrators consider costs when administering care, and has led to ethical discussions about the potential conflict of interest that may exist when costs are weighed against the need for expensive diagnostic tests or treatments. The public expresses a real concern that conflict of interest exists in the managed care setting. It has been assumed that as managed care systems have been adopted, that healthcare organizations should respond to market forces.