Capitation in Healthcare Essay

Capitation in Healthcare Essay

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In this paper I will introduce the topic of capitation in the Health Care System. After a short overview of capitation I would like to address some problems that can arise with its misuse in the system. This problem effects all of us, yet the only disciplines overtly involved in the process of implementation right now are medicine and business (and government if it is not considered business). I will state some of the directions the implementation of capitation in managed care might have us headed hope to address some moral, social and ethical issues that arise when doctors are not paid for quality or quantity, but merely availability. What psychological effects could this have on our drug and dental systems as well as with the emergence and flourishing of the herbal drug market, and what legal consequences could result?

Has anyone noticed that there seems to be a drugstore being built on every corner these days? Revco, Walgreens, and Rite Aid seem to be just a few of the drug store chains that are expanding. One has to wonder if this has anything to do with the possibility of including medicine under coverage by healthcare systems. This means that they may become part of a capitated payment system to the pharmaceutical providers. "By capitation, we mean a prospective payment to physicians or providers - either individually or as a group - of a fixed amount of money to care for each patient (Pearson, 1998)." In other words, every physician is provided a set sum of money whether they see any patients or not and every pharmacy would be given money whether they prescribe any drugs or not. Drug costs will rise.

The question medical groups and IPAs should be asking in the next 10 years is whether they can wisely enter i...

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As more and more people go without any medical insurance, the time for changes in the healthcare industry seems to be now. The government cries for restructuring and the cost coverage of prescription pills should make us step back and question the broad picture. Why would the public benefit from captitation and which segments of the healthcare industry would benefit from which types of capitation? It is important for the public to be educated on our options, healthcare is something that effects us all, old, young, rich, and poor. Why are medical executives determining the directions of cost utilization in the system and not the public? The only thing that seems to be for ceratain is that further research is vitally needed to clarify how capitation truly effects physician-patient relationships, decision making by physicians, and clinical outcomes.

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