Vera is an$85-$year$-$old widow and retiree from a large corporation. Her former employer recently changed the health care coverage for retirees to an HMO. Vera is having difficulty with her knees and has requested a referral to an orthopedist. After ordering$$ X$-$rays, her primary care physician informs her that her knees are not serious enough to warrant knee$$ replacement, and he gives her a prescription to alleviate the pain. Several weeks$$ later, Vera reads an article that doctors in her HMO are rewarded for keeping utilization costs down.

a$.$ Discuss the ethics of HMOs rewarding physicians for keeping utilization costs down.

b$.$ Does Vera have any$$ options?

Part $2$

a$.$ Considering the ethics of HMOs rewarding physicians for keeping utilization costs$$ down, which of the following is$$ true?$($Select the best answer$$ below.$)$

A$.$

If the focus is income for the doctor$,$ patients should be required to pay higher$$ co$-$pays when they see specialists.

B$.$

If the focus is income for the doctor$,$ some rationing of health care is required.

C$.$

If the focus is patient satisfaction$,$ there should be no consideration of cost$.$

D$.$

If the focus is patient satisfaction$,$ patients should be encouraged to challenge the medical advice they receive.