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Books > Business & Economics > Industry & industrial studies
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Making Medical Spending Decisions - The Law, Ethics, and Economics of Rationing Mechanisms (Hardcover, New)
Loot Price: R980
Discovery Miles 9 800
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Making Medical Spending Decisions - The Law, Ethics, and Economics of Rationing Mechanisms (Hardcover, New)
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One of the most fundamental issues in health care delivery is who
should decide which items of medical care are not worth their cost.
This book is a fresh and comprehensive exploration of how health
care rationing decisions are made. Unlike prior works, its focus is
not on the specific criteria for rationing, like age or quality of
life. Instead, the author provides comparative analysis of
alternative social mechanisms for making medical spending
decisions: (1) consumers paying for their medical treatment out of
pocket; (2) payers, government officials, or other centralized
authorities setting limits on what doctors can do and what
insurance will pay for; and (3) physicians motivated to make these
decisions at the bedside level. His analysis of each of these
mechanisms reveals that none is uniformly superior, and each is
better suited for certain decisions that others. Therefore, a mix
of all three is inevitable. The author develops his analysis along
three dimensions: political economics, ethics, and law. The
political economic dimension discusses the practical and
theoretical aspects of each method for making spending decisions,
synthesizing empirical studies of the situations in which each
mechanism has been tested. The ethical dimension is based on
several strands of philosophical theory, principally classic
liberalism, social contract theory, and communitarianism, as well
as conceptual analysis of terms such as autonomy and coercion. The
legal dimension addresses recent developments in legal doctrine
such as informed consent, insurance coverage disputes, and the
emerging direction of federal regulation. Hall concludes that
physician rationing at the bedside is far more promising than
medical ethicists and the medical profession have traditionally
allowed. The best way to allocate authority for making medical
spending decisions in both public and private systems, he believes,
is the informed purchase of different types of health insurance in
a managed competition framework.
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