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The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.
The Ethics of Health Care Rationing: An Introduction by Greg Bognar,Iwao Hirose Pdf
Should organ transplants be given to patients who have waited the longest, or need it most urgently, or those whose survival prospects are the best? The rationing of health care is universal and inevitable, taking place in poor and affluent countries, in publicly funded and private health care systems. Someone must budget for as well as dispense health care whilst aging populations severely stretch the availability of resources. The Ethics of Health Care Rationing is a clear and much-needed introduction to this increasingly important topic, considering and assessing the major ethical problems and dilemmas about the allocation, scarcity and rationing of health care. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics: What is the value of health? How can it be measured? What does it mean that a treatment is "good value for money"? What sort of distributive principles - utilitarian, egalitarian or prioritarian - should we rely on when thinking about health care rationing? Does rationing health care unfairly discriminate against the elderly and people with disabilities? Should patients be held responsible for their health? Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality? Throughout the book, examples from the US, UK and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading and discussion questions make this an ideal starting point for students new to the subject, not only in philosophy but also in closely related fields such as politics, health economics, public health, medicine, nursing and social work.
A rational look at health care rationing, from ethical, economic, psychological, and clinical perspectives. Although managed health care is a hot topic, too few discussions focus on health care rationing--who lives and who dies, death versus dollars. In this book physician and bioethicist Peter A. Ubel argues that physicians, health insurance companies, managed care organizations, and governments need to consider the cost-effectiveness of many new health care technologies. In particular, they need to think about how best to ration health care. Ubel believes that standard medical training should provide physicians with the expertise to decide when to withhold health care from patients. He discusses the moral questions raised by this position, and by health care rationing in general. He incorporates ethical arguments about the appropriate role of cost-effectiveness analysis in health care rationing, empirical research about how the general public wants to ration care, and clinical insights based on his practice of general internal medicine. Straddling the fields of ethics, economics, research psychology, and clinical medicine, he moves the debate forward from whether to ration to how to ration. The discussion is enlivened by actual case studies.
Can We Say No? by Henry J. Aaron,William B. Schwartz Pdf
"Examines the use of rationing as a means to curb health care spending, using the experience of Great Britain to highlight the promises and pitfalls of this approach"--Provided by publisher.
The National Health Service provides poor quality health care, compared with systems in other developed countries. In this book, Heinz Redwood makes detailed comparisons between the UK, France, Germany and the USA, in order to demonstrate just how wide the gap between Britain and the rest of the developed world has become. We spend less of our national wealth on health than countries at a similar level of economic development. In terms of numbers of doctors and nurses, the UK is closer to Mexico and Turkey than it is to France and Germany. As a result, we find ourselves denied the standard of care which people in other countries take for granted, or else we wait so long that some patients die before reaching the head of the queue.
The Ethics of Health Care Rationing by John Butler Pdf
This volume explains why, and in what ways, health care is being rationed in the late-1990s health service. It examines the ethical questions which arise from this rationing and includes personal case studies, from surgeons to geriatric advisors.
One of the world's leading healthcare economists offers a hard-nosed analysisof the frightening reality of soaring healthcare costs--and shows how it willfeel to be at the mercy of a system that can't afford to cure anyone.
In one form or another, health care now gets rationed. Not everything beneficial is done for every patient. For the individual the consequences are sometimes tragic. Rationing decisions thus raise a classic dilemma: how can we treat with dignity and genuine respect the person who gets short-changed by an efficient policy that seems best overall? Strong Medicine argues that we can, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients as well as the doctor ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperiled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers interested in policy questions the book takes up. The issues are fascinating, the arguments are careful, and the results often surprising.
Desperately Seeking Solutions by David J. Hunter Pdf
Following the Governments health reforms in 1991 rationing has been put firmly on the agenda. This book identifies and clarifies the numerous political and ethical issues surrounding rationing in healthcare. Drawing upon international examples it offers a critical overview of the approaches to rationing and makes practical proposals for its management. Desperately Seeking Solutions challenges the assumption that all health services are inherently subject to rationing as demand invariably outstrips supply and examines this within a comparative framework. The author critically evaluates the extent to which rationing has always existed and should exist within the NHS, although until recently it operated on an implicit rather than explicit basis and was bound up with clinical judgements rather than purely financial considerations. The author questions whether calls for explicit rationing are actually desirable and potentially feasible.
Rationing Is Not a Four-Letter Word by Philip M. Rosoff Pdf
In this book, Philip Rosoff offers a provocative proposal for providing quality healthcare to all Americans and controlling the out-of-control costs that threaten the economy. He argues that rationing--often associated in the public's mind with such negatives as unplugging ventilators, death panels, and socialized medicine--is not a dirty word. A comprehensive, centralized, and fair system of rationing is the best way to distribute the benefits of modern medicine equitably while achieving significant cost savings.
Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.
When we're ill, we trust in doctors to put our well-being first. But medicine's expanding capability and soaring costs are putting this promise at risk. Increasingly, society is calling upon physicians to limit care and to use their skills on behalf of health plan bureaucrats, public officials, national security, and courts of law. And doctors are answering this call. They're endangering patients, veiling moral choices behind the language of science and, at times, compromising our liberties. In The Hippocratic Myth, Dr. M. Gregg Bloche marshals his expertise in medicine and the law to expose how: *Doctors are pushed into acting both as caregivers and cost-cutters, compromising their fidelity to patients *Politics keeps doctors from giving war veterans the help they need *Insurers and hospital administrators pressure doctors to discontinue life-saving treatment, even when patients and family members object *Medicine has become a weapon in America's battles over abortion, child custody, criminal responsibility, and the rights of gays and lesbians *The war on terror has exploited clinical psychology to inflict harm Challenging, provocative, and insightful, The Hippocratic Myth breaks the code of silence and issues a powerful warning about the need for doctors to forge a new compact with patients and society.
Unlike the rest of the advanced industrialized world, the United States does not have a national healthcare system that guarantees that all residents have access to medical services. Over the past century a number of unsuccessful attempts have been made to create and implement a unified, coordinated healthcare system. Piecemeal progress has been made, such as with the passage of Medicare, Medicaid, and the Affordable Care Act. However, the US still has the dubious distinction of possessing the most expensive healthcare in the world as well as health-related outcomes that are shameful for a wealthy country, mostly due to the number of people who lack decent care. The continuing escalation in medical costs is also threatening the financial stability of the nation. In his first book, Rationing is Not a Four-Letter Word, Philip M. Rosoff argued that the only way to control costs is to impose rationing, and the only way to do so fairly is to have it apply to all. The key to rationing is how it is accomplished. He outlined a general approach to making rationing decisions that involved a comprehensive explication of procedural fairness and illustrated this with the real-life accepted system of solid organ allocation for transplantation. In this book, he discusses how to decide what should and should not be covered in a generous benefits plan for all. He considers a variety of ways this might be done and concludes that the most just approach is to utilize a transparent process in which experts and lay people develop a consensus on what should be covered by focusing on both clinical evidence of need and the effective and appropriate means to address those needs. He also considers the various objections and impediments to this proposal and concludes that they are obstacles that can be successfully met.
Medicine and Social Justice by Rosamond Rhodes,Margaret Battin,Anita Silvers Pdf
Because medicine can preserve life, restore health and maintain the body's functions, it is widely acknowledged as a basic good that just societies should provide for their members. Yet, there is wide disagreement over the scope and content of what to provide, to whom, how, when, and why. In this unique and comprehensive volume, some of the best-known philosophers, physicians, legal scholars, political scientists, and economists writing on the subject discuss what social justice in medicine should be. Their contributions deepen our understanding of the theoretical and practical issues that run through the contemporary debate. The forty-two chapters in this reorganized second edition of Medicine and Social Justice update and expand upon the thirty-four chapters of the 2002 first edition. Eighteen chapters from the original volume are revised to address policy changes and challenging issues that have emerged in the intervening decade. Twenty-two of the chapters in this edition are entirely new. The treatment of foundational theory and conceptual issues related to access to health care and rationing medical resources have been expanded to provide a more comprehensive and nuanced discussion of the background concepts that underlie distributive justice debates, with global perspectives on health and well-being added. New additions to the section on health care justice for specific populations include chapters on health care for the chronically ill, soldiers, prisoners, the severely cognitively disabled, and the LGBT population. The section devoted to dilemmas and priorities addresses an array of topics that have recently become especially pressing because of new technologies or altered policies. New chapters address questions of justice related to genetics, medical malpractice, research on human subjects, pandemic and disaster planning, newborn screening, and justice for the brain dead and those with profound neurological injury. Reviews of the first edition: "This compilation brings a variety of perspectives, national settings, and disciplinary backgrounds to the topic and provides a unique survey of theoretical and applied thinking about the connections between health care and social justice... Physicians and others interested in this field will find this book an engaging introduction to the theoretical and practical challenges pertaining to social justice and health care." New England Journal of Medicine "Although much work in bioethics has focused on clinical encounters, there has been a current of discussion about questions of social justice for decades-at least since the allocation of access to dialysis was widely understood in the 1960s to be a matter of justice, not of medical judgment. This volume will facilitate heightened awareness and deeper discussion of such issues." JAMA "Impressively, the editors have chosen an array of essays that explore the philosophical and bioethical foundations of distributive justice; review the current practice of rationing and patients' access to care in a number of different countries; highlight the issues raised by various special needs groups; and then wrestle with some dilemmas in assessing priorities in distributing healthcare... This book is an excellent resource. " Doody's
