The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians have a professional obligation and, in many states, a legal duty to report drivers whose functional or cognitive impairments may pose a safety hazard.
State laws often require physicians to report suspected abuse and assault, creating a dilemma for physicians who must not only treat the injured patient but act as an informant to police.
In a study of New York physicians' compliance with reporting of communicable diseases, surveyed physicians responded better to legal warnings than to requests that explained public health benefits.
Several recent court cases illustrate how some states are attempting to mandate physician reporting of all underage sexual activity as instances of child abuse.
Health care policy changes are needed to minimize the risk to physicians responding to public health emergencies and aid in their longer-term responsibility of protecting and promoting the nation's health.