One of the arguments people use to justify our "free market" medical system as opposed to some form of national health insurance is countries with such systems "ration" healthcare. Well, what are we doing with our corporate HMO system? Who elects them?

Via ABC News:

A new study done by the American Medical Association's Institute of Ethics finds that 31 percent of more than 700 doctors surveyed say they sometimes withhold medical information about treatment options from patients when they believe the patient cannot afford them.

Of these doctors, 35 percent were doing so more often than they had in the five years leading up to the 1998 survey. Doctors whose patients were largely poor and unlikely to get appropriate help from their health plans often fall short on disclosing information. The study is published in the latest issue of Health Affairs.

...

According to the study, doctors are often caught between their obligation to provide information and their fear of being asked to cheat insurance companies so that patients can receive care they are not eligible for — a practice called "gaming the system."

It is also suggested that doctors whose revenue is significantly tied to managed care companies tend to hold back information about non-covered treatments to some patients.

Many doctors contacted by ABCNEWS cited time constraints as the number one difficulty. Dr. John Messmer of Penn State Hershey Medical Center says doctors are now expected to explain complicated medical information to patients while having less and less time to do so. They are caught between their duties to their patients and their lack of resources.

"The ethical issue is that we no longer work for patients since we are no longer paid by them. Practitioners who want to be compensated must follow the insurance company's or government's rules, even if we disagree with them," says Messmer.