The MD and the DRG

Cost containment in health care poses enormous challenges to medical values. Morreim considers the effect on physicians of the government's Diagnosis Related Groups (DRG) prospective reimbursement for Medicare. She rejects as morally objectionable three models of the hospital relationship: (1) hospital restrictions on physicians' decisions, (2) sharing of profits and losses, and (3) ad hoc, budget balancing decisions by physicians. Instead, Morreim proposes approach under which physicians would collectively systematize the informal that guide clinical decision making so as to foster economic without detracting from the quality of care. (KIE abstract)