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Unformatted text preview: COMPILED NOTES FOR MIDTERM II PHL325M Class notes for 10/19: I. From 7 th ed what are we teaching about incident patients? Dr. Steven Miles A. Woman goes to the hospital and treated for an overdose and they try and set her broken arm in that same hospital, but she sneaks out and goes to the county emergency room. B. Problem-cannot let people die outside of emergency rooms, emergencies are dealt with in emergency rooms whether it can be paid for or not; the private hospital cant treat her, so she sneaks out and goes to the county emergency room C. We tend to think itd be wrong to let somebody bleed to death outside an emergency room. Perhaps for Kantian reasons, we owe individuals dignity and respect so as to not let them die. Or virtue ethics, doctors wouldnt be virtuous if they worked somewhere where they can save lives and they arent. Uninsured people add about 1000$ to the amount the insured person pays each year. D. This is an example that other attending physicians might think is acceptable, might erode compassion for physicians to have for their patients, might contribute to thinking of individuals as not having certain level of treatment as others. II. The case of Christine deMeurers: A. she has metastatic breast cancer, and there is one last procedure available that has no proven benefit. Insurance company wont pay for it. The deMeurers do something they shouldnt do; they withhold the information that they have Health Net when seeking help from a doctor that can give the treatment, and they present themselves as paying customers when they dont actually have the money for it. The doctor was actually on the board for the insurance company that recommended they not cover the treatment. The UCLA medical center decided to absorb the costs in the end. On one hand, theyre devoting resources somewhere when they probably could have been better spent somewhere else. The woman ended up dying 4 months after treatment, and probably wouldve lived longer without it. However, the husband said it was worth it for the quality of the remaining 4 months she had. The question is: are 4 disease free months worth $100,000? B. The insurance company decided it was not worth covering and raising premiums for it because it was of unproven benefit. The insurance company got the doctor to change his mind about the need for the procedure, when clearly he was for it. This seems very suspicious. The problem is we dont know what the decision-making procedure was for the insurance company. The author claims people will always continue to resent policy that they had no part in shaping. Insurance providers recognize this and have started to put customers and citizens on boards that decide policy....
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This note was uploaded on 11/19/2009 for the course PHL 325M taught by Professor Leon during the Spring '08 term at University of Texas at Austin.

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