An ethical dilemma is a situation where you must make a choice in a matter that could be potentially beneficial, but may not be considered the right thing to do. Many times managers are forced to make choices that morally they do not feel comfortable with but legally they are forced to. This is just one example of an ethical situation that I have faced.
I had a patient who was a new amputee. He had lost his leg because of an injury that occurred in an automobile accident. The patient’s insurance company would only cover 50% of the cost of a prosthesis that was worth $15000. That would have left the patient with a bill for $7500. I knew that the patient would not be able to afford the leg, and I also knew that if we collected $5000 our company would cover our cost. The link on this page will explain how the insurance works. It will tell you about deductibles, coinsurance, and out of pocket maximums.
The patient had lost his job due to his injury and currently had no means of income. He had filed for disability but the process can take years to go through.I made a list of all of the cost that would go into making the prosthesis. The labor, liners and sleeves, and prosthetic components totaled up to just under $5000 dollars. I evaluated the HCPCS codes that would be used and found that the total amount that insurance would allow would be $15,000.
The way that I looked at this I had three different choices:Tell the patient that he would need to pay his half of the estimated bill before services would be provided (standard procedure for medical facilities).Provide the services and allow the patient to make payments on his half of the bill.Bill the insurance company, accept their 50% payment, and write off the patient’s responsibility due to financial hardship.
Asking Him to Pay up Front:It is legal and actually common practice in the medical field to make patients pay their portion up frontI don’t feel like it is right to force someone to wait on medical treatment that they need, simply because they can not afford itThe patient would not benefit from this option, he was in need of a new prosthetic and this would not allow him to get it in a timely manner. The company would only benefit from this option if the patient had the money to pay up front. Without the money to pay the company would be losing out on any profit at all. The video that I chose has a lot of parallels to the “test”. The six thinking caps are just another way of weighing the affects of your decision. Allowing the Patient to Make Payments:It is legal to allow the patient to make payments on his balance after the services are provided. It is a little less clear on how right this option is. This would benefit the patient to receive the leg but he would still be liable for his bill. I don’t think that this would be the wrong thing to do, I just still wouldn’t have felt comfortable leaving him with such a large bill.This option is beneficial to the company. Not only do we receive the money from the insurance company but we also receive any payments that the patient makes. The patient also benefits from the prosthesis that he receives. However, the chances are that the patient will not be able to afford his payments and will be sent to collections. Writing Off the Balance:If a patient is having a financial hardship it is legal.I think that it is right to help a patient that is in need of services. I don’t think that it is right to allow them to have a balance write off and still charge the patients who can afford it.The benefits of this are for both the patient and the company. If we accept the money from the insurance and write off the patient’s balance the company is still collecting $2500 in profit, and the patient is receiving the medical care that he needs without putting him farther into debt.
After speaking with the owner of the company, and going over all of the numbers, we decided to write off the patient’s balance. We felt that the patient was in a very unfortunate circumstance and that we were in a position to help him, without making the business suffer. On top of that we were building a customer relationship that we would be able to benefit from in the future.
How will I feel if my family finds out about my decision?I am confident that my family would be proud of the decision that I made. I don’t think that there would be any negative feedback from family or friends about my choice.How will I feel about this if my decision is reported in the local newspaper or posted on the Internet?I think that there may be a small amount of negative feedback due to the lack of fairness between different patients but I think that the negativity would be minimal. If my choice was posted in the paper or on the internet, I would proudly stand by my choice. I think that majority of the public would feel the same way.
When the patient was scheduled for an appointment we did a financial counseling session with him. I explained the situation and what we were purposing to do. The patient was so happy and grateful that he was in tears. I feel completely confident in my decision and the services that we provided for the patient.
Dealing with an ethical dilemma
Dealing With an Ethical DilemmaBy Tera Weisbender MGT 301