ETHICAL DECISIONS

Ethical Decisions and Their Effect On The Firm

Ethical Decisions and Their Effect On The Firm

Introduction

In this paper, I have selected Blue Cross / Blue Shield, one of the most reputable privately-owned insurance organizations or plans operating in North America. But for this paper, I have chosen this company because of ethical decision making issue that brought the firm a bad name. Blue Cross and Blue Shield are independent, locally operated insurance plans. They have existed for over 70 years. One in four Americans carry this insurance. The Blue Cross Blue Shield Association is the trade association for 43 local member companies.

Thesis Statement

At the heart of the healthcare insurance profession is the all-important relationship between the insurance firm and the individual, couple, group, or family seeking help. Because the relationship itself is so central to the helping process, ethical concerns and obligations are especially salient and compelling. This relationship entails an important power differential between the professional and those seeking insurance assistance, thus making ethical behavior an essential responsibility of the professional.



About Blue Cross and Blue Shield

In the beginning, Blue Cross and Blue Shield Plans marked the birth of prepaid health care coverage in America. Blue Cross was for hospital care coverage, and Blue Shield included physician services. Most plans have now combined to offer both services under one umbrella (www.bluecares.com).

Blue Cross began in 1929 to guarantee hospital coverage for schoolteachers in Dallas. Soon other groups joined, and national attention was drawn to the plan. Around the early 1900s, Blue Shield was born in the mining and lumber camps in the Pacific Northwest. Physicians were paid monthly fees to provide medical care for the laborers. The Blue Cross and Blue Shield Association is the result of a merger between the Blue Cross Association and the National Association of Blue Shield Plans (www.bluecares.com).

In the 1920s, the Blue Cross and Blue Shield companies were the first to forge partnerships with physicians and subscribers. Instead of just paying for health benefits, they created partnerships with hospitals, physicians, and other health care providers.

Although they were traditionally not-for-profit companies, some plans, such as the Empire Plan of New York, have applied for and been granted for-profit status. Blue Choice Senior Plan is a division of Blue Cross Blue Shield that deals with the Medicare population.



Discussion

The welfare of the client is the predominant ethical concern of the health insurance professions. Ethics codes emphasize this reality by delineating the domains considered to be essential to a healthy counseling relationship. Most importantly, clients are entitled to an informed consent process that allows them to understand the helping (or therapeutic) process, make decisions regarding their participation, and have a reasonable understanding of the expected process and outcome of insurance settlement (Ettinger, 2008). Clients have a right to know the theories and techniques that guide their counselor, the price of the services they will receive, the limits of confidentiality, the training and professional memberships of their counselor, and the likelihood that the counseling they will receive will be ...