Abstract

A health insurer vertically concerned about the high cost of laboratory tests requested from patients and prescribed medications, decides to make the decision to create economic incentives for doctors who perform fewer tests. request patients and those that stand out for the lower total value of the medications formulated in each quarter of the year.

The Manager of the insurance company and the Director of the Hospital where they see many of their patients, meet with all the doctors linked to the providing institution and after raising concerns about the increasing cost of health care for patients and its impact on the future sustainability of the institution. insurer and indirectly the health system, informs them of the decision they have made to encourage the rational use of laboratory tests and medications. He explains to them that the ranking of doctors will be published quarterly according to these two items and those who are in the first places with the least use will be given a financial stimulus.

Doctors generally agree with the decision with the exception of a small group who oppose it, considering that this decision will negatively affect the quality of medical care and will imply a violation of the ethics that should govern the doctor-patient-health institution relationship. . Since their claim to the institution and insurer was not echoed, nor support from many of their colleagues, they decided to consult a Medical Ethics Committee about it..