What produces value in managed care is a good health outcome rather than medical intervention. Not every visit to a doctor is necessary; nor is every test conducted, every medication prescribed, or every placement in an intensive care unit going to produce an effective outcome. Ideally, medicine should be ruled by rationality and efficiency in the choice and implementation of evaluations and treatments. This means that the variability between providers not only should be but can be eliminated, and the only factors that should make a difference in deciding who to treat and what treatment to undertake is the nature of the patient's disease or injury (Birenbaum, 14)."

What these opposing views tell the insured, the uninsured, and those of us who rely on the expertise and ethical practices in an industry that has our very lives in their hands, is that they're not making decisions in our best interest - from either side of the argument, and that their action and their interests are profit based. This tells the public two things: first, that there is a need for private based and funded research in order to understand the implications of what is happening in our healthcare system as it pertains to the question of unnecessary surgeries. Second, it suggests that healthcare reform must include a component for policing the decisions of insurers and physicians who have failed to exercise ethical judgment in performing surgeries on patients, and who have left them at risk to other life threatening conditions as a result. There must be penalties imposed upon the industry and professionals who would take advantage of the public, especially women and children.

In order to perpetrate the fraud of unnecessary surgery, the physician must prey upon the fears of the patient that he or she is proposing to perform surgery on. This brings into play the issue of mental abuse, because it is causing fears in the patient that they would not otherwise have or experience, and they...

To prey upon patients in this way is not acceptable, and there must be strict guidelines designed that do not prevent the patient from having a necessary surgery in a timely fashion, but at the same time helps to ensure that the patient is not being referred for a surgical procedure that is unnecessary. For physicians and healthcare providers who are found to deliberately and knowingly perform unnecessary surgeries, this should be considered a crime, and should be punished with high penalties, financially, and personally.
As Americans move toward a health insurance coverage system that requires them to participate in health insurance programs, it is even more important that health insurers, physicians, hospitals and all healthcare providers work to ensure that access to surgical procedures is based on sound, medical criteria and referral practices.

Works Cited

http://www.questia.com/PM.qst?a=o&d=78592345

Beck, Christina S., Sandra L. Ragan, and Athena DuPrae. Partnership for Health: Building Relationships between Women and Health Caregivers. Mahwah, NJ: Lawrence Erlbaum Associates, 1997. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=78592347.

A www.questia.com/PM.qst?a=o&d=27467039

Birenbaum, Arnold. Managed Care: Made in America. Westport, CT: Praeger Publishers, 1997. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=27467039.

A www.questia.com/PM.qst?a=o&d=93797995

Gollaher, David L. Circumcision: A History of the World's Most Controversial Surgery. New York: Basic Books, 2000. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=93797997.

A www.questia.com/PM.qst?a=o&d=89793096

Leyerle, Betty. The Private Regulation of American Health Care. Armonk, NY M.E. Sharpe, 1994. Questia. 23 Mar. 2009 http://www.questia.com/PM.qst?a=o&d=89793098.