Physician Charity Care in America: Almost Always an Illusion, Ever More Commercial

Bruce D. White and Marleen Eijkholt
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Bruce D. White: Alden March Bioethics Institute (AMBI), Albany Medical College, Albany, NY 12208, USA
Marleen Eijkholt: Department of Medical Humanities, Davidson College, Davidson, NC 28035, USA

Laws, 2015, vol. 4, issue 2, 1-15

Abstract: The first Code of Medical Ethics promulgated by the American Medical Association (AMA) in 1847 included a provision that essentially obligated physicians to care for those in their communities who could not afford to pay for professional services. The spirit of that provision remains embodied in today’s Code . However, a “charity care” ethical obligation may not make as much professional sense as it once did. Health care institutions have assumed a much greater role in providing charity care and many physicians are now under legal and quasi-legal obligations to provide care in some cases. Under the recently enacted Affordable Care Act (ACA)—if fully implemented—it is theorized that as many as 95% of Americans will be covered by some basic insurance plan. Perhaps today’s physicians should tailor the charity care mandate into a new jacket, which envisions that all doctors share equally in the care for those without adequate means. An individual obligation may have to make way for a more communal one in professional codes. Moreover, it may be wise to consider if there are any lessons to draw from other health care systems (e.g., the Dutch), where questions about charity care still exist within a universal health care system context.

Keywords: health care; physician; hospital; charity care; United States; ethics; code of ethics; American Medical Association; commercialization; Affordable Care Act (search for similar items in EconPapers)
JEL-codes: D78 E61 E62 F13 F42 F68 K0 K1 K2 K3 K4 (search for similar items in EconPapers)
Date: 2015
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