{"title":"Payers are Morally Responsible for Reimbursing Social Care by Medical Facilities: How to Make Value-Based Payments Work for Vulnerable Patients.","authors":"Jacob Riegler","doi":"10.1017/jme.2024.167","DOIUrl":null,"url":null,"abstract":"<p><p>Payers have shaped the healthcare system in the United States as fee-for-service has facilitated a care model that prioritizes volume over the sake of patient care. This worsens health disparities, especially in safety net facilities where ancillary social work is both necessary clinically and completely uncompensated. Using concepts from Iris Marion Young's Responsibility for Justice, it can be concluded that payers have a moral responsibility for reimbursing social care to address historical injustices. In this article, I describe the ethical hazards in paying for social care and propose a way to finance this through value-based payments.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"52 4","pages":"883-902"},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Law Medicine & Ethics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/jme.2024.167","RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/31 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
Payers have shaped the healthcare system in the United States as fee-for-service has facilitated a care model that prioritizes volume over the sake of patient care. This worsens health disparities, especially in safety net facilities where ancillary social work is both necessary clinically and completely uncompensated. Using concepts from Iris Marion Young's Responsibility for Justice, it can be concluded that payers have a moral responsibility for reimbursing social care to address historical injustices. In this article, I describe the ethical hazards in paying for social care and propose a way to finance this through value-based payments.
付费者塑造了美国的医疗保健系统,因为按服务收费促进了一种优先考虑数量而非病人护理的护理模式。这加剧了健康差距,尤其是在安全网设施中,辅助性社会工作在临床上是必要的,但却完全没有报酬。利用 Iris Marion Young 的《正义的责任》一书中的概念,我们可以得出这样的结论:支付方有道德责任对社会医疗进行补偿,以解决历史上的不公正问题。在这篇文章中,我阐述了为社会医疗付费的道德风险,并提出了一种通过基于价值的付费方式为社会医疗付费的方法。
期刊介绍:
Material published in The Journal of Law, Medicine & Ethics (JLME) contributes to the educational mission of The American Society of Law, Medicine & Ethics, covering public health, health disparities, patient safety and quality of care, and biomedical science and research. It provides articles on such timely topics as health care quality and access, managed care, pain relief, genetics, child/maternal health, reproductive health, informed consent, assisted dying, ethics committees, HIV/AIDS, and public health. Symposium issues review significant policy developments, health law court decisions, and books.