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Financial/business decisions in medicine are outside the venue of the Hippocratic oath. Of course, in emergency situations a doctor gives no thought to whether the victim has insurance or not. Remember, too, that a physician has to pay for malpractice insurance, etc., and that the insurance business is a profit-making enterprise. If a doctor will only take patients whose financial situation guarantees payment, that is not unethical, any more than a car dealer who refuses to sell a car to someone with a bad credit rating is unethical. For instance, many doctors will not accept Medicare, because the rates of payment are too low. Hospitals, too, may refuse treatment for financial reasons, although they will accept anyone through their Emergency Program. That is one of the major problems today—persons who cannot afford health insurance use the emergency service for non-emergencies. Now, that could be considered unethical. A final note: Virtually all doctors treat on a pro-bono basis, or volunteer their time in clinics, etc.
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