Deceptive Health Insurance Practices

Deceptive Health Insurance Practices

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Deceptive Health Insurance Practices

Is it ethical for doctors to bend the truth in order to get an insurance company to pay for medical treatment? According to this article, most doctors do. A survey has shown that 58% of doctors say that they would be willing to give an insurance company "deliberately deceptive documentation" to influence the company's decision to approve surgery or other treatment for a life-threatening illness.

These doctors believe that if they did not lie, their patients would receive sub-standard health care. Insurance companies are continually looking for ways to reduce their costs, and the most common way is to second-guess the doctors' opinions or to approve the minimum treatments necessary. This has created a crisis in American medicine in which doctors feel they must be dishonest with the insurance companies in order to be the "good guy" to their patients.

Does the end justify the mean? After all, these doctors seem to have a good reason for lying. They are trying to help someone, right? But it does not make it morally and ethically right. Lying is wrong, no matter what the reason is. Even though saving someone's life seems to be a valid reason for bending the truth, it does not solve the problem. It is unethical for a doctor to lie, even to an insurance company. Although
HMO's and insurance companies need to be dealt with, lying is not the way to defeat them. You should not lie to "beat the system." It solves nothing. Lying is a quick fix. It may work on a case-to-case basis, but health care reform is the only permanent solution.

While we can condemn doctors for being untruthful, we also have to look at the flip side -- HMO's and other insurance companies who are trying to cut back costs, approving the least expensive treatments and sometimes denying those claims that have real merit. These companies do breed an environment where it is difficult for doctors to be completely honest. Doctors are supposed to be looking after the interests of their patients, and they sometimes see lying as the only way to skirt the policies of some HMO's.

The author takes the position that it is morally and ethically wrong for doctors to lie to insurance companies. However, in the current health system, dishonest pays.

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This creates a continuous cycle of corruption. The integrity of the medical community is at stake -- and patients have become the pawns. Health insurance companies have indeed created the problem -- but lying is not the answer. "This cycle of deception begetting new rules begetting new deceptions could continue indefinitely." The author's opinion appears unbiased. He presents the facts and both sides of the issue, and condemns them both.
Perhaps someday we can agree upon a reasonable system where the needs of the patient come before the wallet of the insurance company. Only then will doctors feel that they are not obligated to lie and integrity will be restored to the American health system.




Bibliography:

Doctoring the Truth. The New Republic. Nov 15, 1999. P 13.
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