Question

How do the tensions between insurance coverage and the need for care impact a hospital’s economic, ethical and legal responsibilities?

Answer 1

Tension between insurance coverage and the need for care impacts a hospital's economic, ethical and legal responsibilities as it is dilemma they face between providing quality healthcare, reimbursement of expenses by the insurance compabies, cost effectiveness goals of the organization and the various insurance players in the market with there different rates and schemes.

Economic responsibilities of a hospital includes the physician's prescribe the best possible healthcare solutions which are as per the needs of its patients and consumers. The hospital also need to provide the various solutions available to the patients in terms of costs and benefits so that their is transparency and trust between the healthcare provider and patients. Legal responsibilities include no dicrmination of patients based on their economic status or other such considerations. The healthcare providers need to work with the insurance providers as per the rules and regulations.

The legal, economic and ethical goals need the healthcare organizations or hospitals to develop a mechanism of providing services which are as per organization's goals as well asin the benefit of patients and creates a long term and responsible relationship with society as well as authorities and other stakeholders involved in this process like government, insurance providers, patients and physicians. There should be no compromise in the quality of healthcare and patient's care growth, at the same time the organization need to follow sustainable practices in terms of cost and its obligations to other stakeholders.