1. What are the choices and trade-offs, Dr. Solomon has to make between medical care and his own financial survival?

2. Should he be concerned with his 'duty' to his patients as a physician and the financial 'consequences' of his actions to himself and the hospital, why or why not?

3. There was this patient that recieved a CABG. The insurance company paid the hospital a flat fee for this surgery of $30,000. He was discharged from the hospital in 72 hours. 4 days later he is admitted again with a staph infection and is hosptalized for three more weeks because they had to open his chest and clear up the infection. Who had to absorb the major part of the cost of his additonal visit?

4. At Joslin , they say the mission of doctors and the hospital is "to take care of the patient". But it is felt that the hospital may have to cut back on some of its mission and drop services. At Joslin Clinic there was this diabetic pregnant women and she recieved optimal care, doctors, nurses, dieticians, ultrasounds about 33 vistis to control the mother's glucose and bring the baby to term. The baby was born healthy and full term with no complications. Would it be a good thing for Joslin Clinic to cut back on its mission and reduce services to pregnant diabetic women? why or why not? What might be the financial and health consequences for cutting back the mission?

5. Do you think a patient that has a heart attack and is very ill should stay in the hospital and run up $600,000? Who will pay for his care? Who should pay for it and why? Should there be a limit to the care we provide to patients like him?