Volk v DeMeerleer may conflict with professional guidelines regarding physicians’ obligations to breach patient confidentiality to protect third parties.
AMA J Ethics. 2018; 20(1):10-18. doi:
10.1001/journalofethics.2018.20.1.peer2-1801.
An undercurrent in all debates about allocation of health care resources to the poor is the matter of access to and coverage of health care for immigrants, particularly low-income and undocumented ones.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
With the U.S. Supreme Court likely to decide on the constitutionality of the Affordable Care Act, it is instructive to understand the relevant policy positions of the largest physician organization in the country.
The social-justice question we must pose to physicians is: Are you willing to advocate for changes to the medical system that creates the need for you to take on charity care in the first place?
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.