Ethical considerations in health care benefits administration

Defining the scope of coverage and limitations in various health plans has become an increasingly difficult and confusing issue. The historical shift to managed care has fundamentally altered the limitations on health care benefits. Because of the existence of "benefits exclusions," confus...

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Bibliographic Details
Published in:Benefits quarterly 1998, Vol.14 (1), p.24-29
Main Author: Singer, S E
Format: Article
Language:English
Subjects:
Business ethics
Cosmetic surgery
Employee benefits
Ethics
Ethics, Institutional
Exclusion
Group health insurance
Health administration
Health Benefit Plans, Employee - organization & administration
Health Benefit Plans, Employee - standards
Health care
Health Care Rationing
Health maintenance organizations
Health Services Needs and Demand
HMOs
Insurance Coverage
Insurance policies
Long-Term Care
Managed care
Managed Care Programs
Personnel Management - standards
Reconstructive surgery
Salaries and Fringe Benefits
Society
Surgeons
United States
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Summary:Defining the scope of coverage and limitations in various health plans has become an increasingly difficult and confusing issue. The historical shift to managed care has fundamentally altered the limitations on health care benefits. Because of the existence of "benefits exclusions," confusing issues have emerged in managed care situations. Fundamental fear of health care rationing has raised the awareness of the general public to the ethics of this issue. This article discusses the definitions and examples of certain types of health benefit exclusions and the ethical considerations related to such exclusions.
ISSN:8756-1263
2168-3336