Describe the ethical concerns related to payment systems reform

The inability to achieve value for money and high healthcare costs are ethical problems.
When the cost per unit of benefit delivered is very high, then the health needs met are relatively
lower than what an efficient healthcare system would achieve. Health is important, but it is not
the only important social good. When a lot of money is spent on acquiring healthcare services,
then the resources available to spend on other social goods such as job creation and education are
lesser (Erickson et al., 2020). Thus, cost containment is necessary. It entails setting priorities and
ensuring that acquiring healthcare is achieved without exerting unsustainably high pressure on
the national debt.
The payment reform is aimed at promoting value for money incurred to acquire
healthcare services. Value for money is an ethical issue. Instrumentally, value for money is
achieved if priorities are set, as this is the only way to ensure that all needs are fairly met.
Fairness can be achieved through efficiency in healthcare, containment of costs, as well as
putting measures on how to set priorities. Decisions that pertain containing costs are morally
contentious (Erickson et al., 2020). They should be made in a way that enhances their legitimacy.
Priorities should be deliberated in a transparent way where all ethical arguments and evidence
are considered. In light of new considerations, decisions made need to be revised accordingly.
There exist ethical imperatives in the process of expansion of access to care while at the
same time, conserving the resources. As such, payment systems reform must include a collection
of features for them to be ethically sound. The realization of ethical goals through the
implementation process is not guaranteed as healthcare policies and reforms are influenced by
the political process. Ethical analysis is necessary as it ensures that the reforms are structured in

UNIT 4 INDIVIDUAL PROJECT 3
a manner that enhances the fulfillment of ethical principles and consequent realization of full
benefits over time (Erickson et al., 2020). The ethical analysis creates a distinction between
morally ethical goals from those that are categorized in the political domain. A comprehensive
payment systems reform is critical in the achievement of a healthy, affordable, caring, and
equitable healthcare system.
Discuss how payment systems impact the physician-patient relationship.
The physician-patient relationship is founded on trust. The payment systems in place
usually place the physician at risk for providing services to patients. The perception and attitudes
of patients could be shaped by how their physicians are paid. The payment system has an impact
on the trust that patients have with their physicians. Study shows that patients have low trust in
physicians who are salaried (Lee et al., 2019). Physicians who work under managed care
organizations and medical groups and whose physicians are salaried are not popular among
patients (Lee et al., 2019). Patients fear that they may get lower quality healthcare services
because the physician has no incentives. However, even in such settings, when patients do not
know how much the physician is paid, their trust levels are high compared to those who know
the amount of money that physicians take home as salaries. On the other hand, patients who have
health plans and trust them also tend to trust their physicians. Further, the level of confidence
that patients have in their health plan influences their trust in their physicians. Studies show that
there is a high probability that this relationship is bidirectional (Lee et al., 2019). This shows that
the payment system affects the trust that patients have on the physicians, and this consequently
influences the relationship between them. This is because the physician-patient relationship is
based on trust. Thus, any factor that affects trust also has an impact on the overall relationship.

UNIT 4 INDIVIDUAL PROJECT 4
Do you believe that most health care institutions are financially responsible organizations?
In other words, do they spend their money wisely? Explain your answer.
I believe that most health care institutions are financially responsible organizations.
These organizations spend the money paid for healthcare services to improve the services
provided. They also spend the money to pay physicians and other professionals who work to
ensure that patients receive quality care. The inflationary economy has made it almost impossible
for health care providers to charge lesser for their services (Ginter et al., 2018). health care
organizations, especially those that operate for profit, have been established with two main
objectives. First, the owner or owners want to provide healthcare services. Secondly, they want
to make a profit even as they provide such services. Due to an increase in the number of
physicians and organizations that provide healthcare services, there has been competition in the
market, making it necessary to provide efficient and quality services. These organizations thus
spend their finances responsibly to ensure that they provide quality care in an efficient manner.
The aim is to have more patients visit their facilities, and this happens if the care provided is of
good quality. Thus, I believe that these organizations spend their finances in a responsible way as
this enables them to improve their services and remain in business.

UNIT 4 INDIVIDUAL PROJECT 5

References

Erickson, S. M., Outland, B., Joy, S., Rockwern, B., Serchen, J., Mire, R. D., & Goldman, J. M.
(2020). Envisioning a Better US Health Care System for All: Health Care Delivery and
Payment System Reforms. Annals of Internal Medicine, 172(2_Supplement), S33-S49.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care
organizations. John Wiley & Sons.
Lee, T. H., McGlynn, E. A., & Safran, D. G. (2019). A framework for increasing trust between
patients and the organizations that care for them. Jama, 321(6), 539-540.