ABSTRACT
The federal government has been considering whether to prohibit Medicare-participating health maintenance organizations and other comprehensive medical plans from offering financial incentives to physicians for reduced medical costs. The prospects for insolvency of the Medicare program have led the government to explore alternative health-care delivery systems as a cost-saving strategy. Most plans attempt to pass on a portion of the risk for the costs of care to participating physicians in the form of risk-sharing payment arrangements. The traditional, normative model of clinical ethics argues that a physician ought to be motivated primarily by consideration of the patient's welfare. Many ethicists who support traditional model are concerned that financial incentives to reduce cost will create conflict with the physician's traditional obligation to serve patients. Cost-containment incentives have the potential to create conflict between the financial interests of the physician and the best medical interests of patients.
