Lying to Insurance Companies: The Desire to Deceive among Physicians and the Public
Read the abstract below of the article "Lying to Insurance Companies: The Desire to Deceive among Physicians and the Public" by Rachel M. Werner, G. Caleb Alexander, Angela Fagerlin, Peter A. Ubelin the Fall 2004 issue of The American Journal of Bioethics 4(4):53.
"This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 700 prospective jurors and 1617 physicians, the public was more than twice as likely as physicians to sanction deception (26%versus 11%) and half as likely to believe that physicians have adequate time to appeal coverage decisions (22%versus 59%). The odds of public support for deception compared to that of physicians rose from 2.48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources. "
If you were the patient's physician who by professional standards of medical care needed a test or procedure but which required your time taken to make an appeal to an insurance company and you knew that your appeal may be rejected because the findings would not meet the company's requirements, would you take a risk of defrauding the insurance company with false history or physical findings which would make acceptance of the request more likely?
After all, you might rationalize, your doing this for the medical and financial benefit of your patient.
But what if you are a patient with the same scenario. Would you ask your physician to deceive your insurance company for your own benefit?
I will write more about this professional ethical and legal issue later.