ABSTRACT
Health plans have been slow to disclose to patients the financial incentives they use with physicians. 1 Studies have shown that physicians deceive third-party payers to secure benefits for their patients and that patients ask their physicians to lie to their health plans. 2 In view of this, it is worth asking whether patients may eventually deceive their physicians in order to secure benefits. Could medical care be delivered in such a context? If, as some have argued, deception is commonplace in business, 3 can the truth-telling paradigm of the marketplace be imported into medicine without sacrificing too much of what is valuable in medicine? Many people believe that business organizations endorse a model of truth telling different from the one used in other contexts, and perhaps different from the one that exists in medicine. 4 As we saw in the last chapter, shareholder primacy may commit organizations to a zealous pursuit of profit maximization and to the values that ensure such profits. This is not to say that all business is 'bad' or to deny the plausibility of the popular maxim, 'doing well by doing good.'
