A broad-ranging introduction to the provision, funding and governance of health care across a variety of systems. This revised fifth edition incorporates additional material on low/middle income countries, as well as broadened coverage relating to healthcare outside of hospitals and the ever-increasing diversity of the healthcare workforce today.

One of the most urgent issues facing the United States today is how to establish a comprehensive health insurance program at a time when nearly one in seven Americans lack insurance and costs for health care and medical fees are increasing at about 20 percent annually. An interdisciplinary team of experts provides a unique overview of the most important current problems and speaks to the key questions of risk, allocation, and equity. This text is designed for college, university, and professional courses in health and medical policy, public policy, public administration, law and society, bioethics, nursing, science and technology, and hospital administration. This public policy study offers a general framework for assessing health insurance from many vantage points, in terms of health policy impacts, the care of the needy, health insurance implementation, and prevention and risk. Chapters assess various national health insurance proposals, current congressional action and Medicare decisions, the social impacts of health insurance policy, coverage for displaced workers, the uninsured and hospital care in the inner city, charity care and community benefits, insuring high-risk persons, preventive health care screening for older women, and medical malpractice insurance, among other subjects. These analyses with real-life examples provide a solid introduction to all who want to understand health insurance and public policy issues today.

Written by experts, this first encyclopedia about U.S. biomedical policy since the 1970s covers a broad array of key issues and developments in human genetics, reproduction, neonatal intensive care, organ transplantation, intervention in the brain, and medical interventions at the end of life. This easily accessible reference describes court cases, legislation, public policies, technologies, issues, key government agencies, and private organizations dealing with the complex economic, cultural, social, and political context for biomedical decisionmaking today. A chronology, directory of major organizations, carefully selected sources for further reading, and index further enrich this interdisciplinary guide designed for students; teachers; policymakers; public administrators in college, university, and institutional libraries; and general readers in public libraries. This easily accessible reference describes court cases, legislation, public policies, technologies, issues, key government agencies, and private organizations dealing with the complex economic, cultural, social, and political context for biomedical decisionmaking today. A chronology, directory of major organizations, carefully selected sources for further reading, extensive cross references and index further enrich this interdisciplinary guide designed for students; teachers; policymakers; public administrators in college, university, and institutional libraries; and general readers in public libraries.

An exploration of the policy dilemmas with new fertility control techniques, this volume offers the first comprehensive treatment of the subject's technical, legal, and political dimensions. Robert H. Blank provides a detailed discussion of current state laws and court decisions, and extensive analysis of new fertility control techniques and their social and policy implications. Blank describes the political, institutional, and constitutional context of fertility control in the United States, examining the relationship between social structures and rapid advances in biomedical technology. He details innovations in fertility control, particularly reversible methods, and reviews the legal context of both voluntary and non-consensual sterilization. Examining the myriad contemporary policy issues relating to fertility control, this book offers insights for devising a rational fertility control policy that will maximize benefits and minimize potential abuses. Written for the informed layperson, it is will also be valuable to professionals in health, policy analysis, bioethics, family planning, and public policy.

No single area of medicine promises more acrimonious and intense debate in the coming decades than the implications of new medical technologies on the maternal-fetal relationships. This is the only book to combine comprehensive coverage of the legal and social issues raised as a result of both emerging technologies for fetal intervention and increasing knowledge of fetal development. It examines such issues as the effects of maternal behavior on the fetus's health, hazards in the workplace, teenage pregnancy, and the use of therapeutic and diagnostic techniques. The volume also summarizes the legal/political context of policies regarding the mother's responsibility for the welfare of the fetus and describes the current status of these issues in public law. The work opens with a framework for examining rights and, in chapter 2, gives an in-depth description of knowledge about the impact of maternal actions on fetal development. Attention then turns to current trends in case law, as Chapter 3 traces the growing acceptance of causes of legal action for prenatal injury or death of the fetus. Chapter 4 extends this analysis to look at the changing legal context for defining standards of care for pregnant women. Chapter 5 examines three disparate but critical topics illustrating the pressures women face in the 1990s: workplace hazards, teenage pregnancy, and surrogate motherhood. The final chapter integrates the technological, legal, social, and political dimensions surrounding the maternal-fetal relationship into a context for creating an effective public policy.

This volume is designed to provide a framework for studying the public policy implications of a broad range of biomedical technologies. Each chapter focuses on the policy issues and political activities surrounding a single technology. Contributors address such issues as new reproductive technologies, animal experimentation, contraceptive drugs, genetic markers and technology and the aging society.

A comprehensive and thoughtful analysis of human reproduction issues in the U.S. with emphasis on the ethical and policy implications of cutting-edge reproductive technologies. Human cloning. Stem cell research. Abortion. All of these subjects are surrounded by controversy. But now readers can cut through the usual emotion, misinformation, and distortion-and get a fair and balanced picture of human reproduction issues in the United States. Few subjects are as divisive and partisan as the issues surrounding the propagation of the human species. This thorough examination covers the full scope of the debates and offers an up-to-the-minute survey of the controversial technologies that are at the heart of reproductive rights in the United States. The areas explored range from abortion and sterlization to fetal research and human cloning. The moral, societal and public policy implications of each subject are examined thoroughly, with emphasis on those areas where cutting-edge technology has raced ahead of public policy, thereby creating new concerns for ethicists and policy-makers. Legislative oversight or the freedom to pursue reproductive technologies at any cost, this debate is far fr

In April 1982, an infant boy was born in Bloomington, Indiana, with Down syndrome and a defective, but surgically correctable, esophagus. His parents refused to consent to surgery or intravenous feeding. The hospital unsuccessfully sought a court order to force treatment, and appeals to higher courts also failed. The child, identified as Baby Doe by the news media, subsequently died. The events in Bloomington became the catalyst for action by the Reagan administration, the courts, and Congress that culminated in a federal policy that makes failure to treat newborns with disabilities a form of child neglect. This book centers on the public policy aspects of withholding treatment from critically ill newborns who are disabled. Specifically, it deals with why the policy was enacted and what impact it has had on health care workers, families, and infants. Some of the contributors to this book spearheaded the early debate on withholding treatment. Anthony Shaw's New York Times Magazine article in 1972 was the first to address these issues in the popular press. The following year, he published a related article in the New England Journal of Medicine. Also appearing in this same issue of NEJM, was the pathbreaking study, coauthored by A. G. M. Campbell, on withholding treatment in the special care nursery at Yale-New Haven Hospital. Each of these articles promoted much public and professional discussion.

This book examines the development of biopolitics as an academic perspective within political science. It reviews the work of the leading proponents of this perspective and presents a comprehensive view of biopolitics as a framework to structure political inquiry. The book's chapters present a range of analysis, critique and recommendations for the current study of biopolitics. Coverage includes; the implications of biopolitics for political theory and the need to re-evaluate basic assumptions of the prevailing political science paradigm; an analysis of the methodological concerns of adopting a more biology-based approach to political science; the current state of knowledge of the genetic and neurological bases of mass and elite behavior; and biopolicy issues and the proper role of the life sciences in informing our understanding of them. The concluding chapter restates the case for a paradigm shift toward an interactive model, arguing that, rather than lead to biological determinism as denounced by some, this inclusive paradigm allows us to counteract deterministic protestations more effectively than by continuing to ignore or minimize biological influences.

This book focuses on the public policy and political/ethical dimensions of ALS/MND across a wide selection of countries and argues for the need of a multidisciplinary and international approach. Policy issues addressed include adequacy of funding for research and care, payment policy and regulatory functions of public and private insurers, long-term services and caregiver support, public health and prevention efforts, access to genetic testing and assisted technologies, ensuring a competent and adequate workforce especially for hands-on caregivers, and the challenging issues of providing palliative and hospice care for ALS/MND patients, advance directives and assisted suicide that face policy makers in all political jurisdictions.

Rapid advances in cognitive neuroscience and converging technologies have led to a vigorous debate over cognitive enhancement. This book outlines the ethical and social issues, but goes on to focus on the policy dimensions, which until now have received much less attention. As the economic, social and personal stakes involved with cognitive enhancement are so high, and the advances in knowledge so swift, we are likely to see increasing demands for government involvement in cognitive enhancement techniques. The book therefore places these techniques in a political context and brings the subsequent considerations and divisions to the forefront of the debate, situating their resolution within the milieu of interest group politics. The book will provide a starting point from which readers can develop a balanced policy framework for addressing such concerns.

Human genetic technology has advanced rapidly in recent years to the point where amniocentesis is commonplace and in vitro fertilization has been successful. On the horizon looms the specter of human cloning and genetic engineering, raising a storm of new moral and ethical questions. These questions, asserts the author, are not the only ones to be considered; the impact and role of public policy are equally critical. What part should the state play in human genetic intervention? To what extent does a democratic society have the duty to take steps to reduce genetic disease and improve the quality of life through genetic engineering? If society has such responsibility, at what stage does societal good preempt individual rights? What is society's obligation toward future generations and is genetic manipulation justifiable on these grounds? After surveying the state of the art, the author grapples with these questions, contending that decisions ultimately will not be based on ethical and moral grounds -they will be fought out in the political arena.

This book examines critical social-policy issues emerging from recent developments in human reproductive technology. Although considerable attention has been focused on the ethical dimensions of these developments, the policy dimension has largely been obscured. Dr. Blank now provides a far-ranging overview of the cumulative impact on society of a wide array of new reproductive technologies and the social patterns that accompany or precede their application. The book begins with a description of the current context of reproductive decision making. Dr. Blank demonstrates how emerging technologies are producing complex and intense social-policy concerns, then reviews in detail human reproductive technologies, and illustrates the significant consequences of technological innovations for political and legal concepts of rights and obligations. (Examples include recent cases involving torts for wrongful life.) He analyzes possible alterations in the moral and legal status of the fetus in light of apparent technological and social-policy trends and presents a paradigm of fetal rights that reflects these changes. A final case is made for a comprehensive assessment of reproductive technologies, as well as for the urgent need to refine concepts of human life that in the past have been taken for granted, but that now are being challenged.

Human genetic technology has advanced rapidly in recent years to the point where amniocentesis is commonplace and in vitro fertilization has been successful. On the horizon looms the specter of human cloning and genetic engineering, raising a storm of new moral and ethical questions. These questions, asserts the author, are not the only ones to be considered; the impact and role of public policy are equally critical. What part should the state play in human genetic intervention? To what extent does a democratic society have the duty to take steps to reduce genetic disease and improve the quality of life through genetic engineering? If society has such responsibility, at what stage does societal good preempt individual rights? What is society's obligation toward future generations and is genetic manipulation justifiable on these grounds? After surveying the state of the art, the author grapples with these questions, contending that decisions ultimately will not be based on ethical and moral grounds -they will be fought out in the political arena.

This book examines critical social-policy issues emerging from recent developments in human reproductive technology. Although considerable attention has been focused on the ethical dimensions of these developments, the policy dimension has largely been obscured.Dr. Blank now provides a far-ranging overview of the cumulative impact on society of a wide array of new reproductive technologies and the social patterns that accompany or precede their application.The book begins with a description of the current context of reproductive decision making. Dr. Blank demonstrates how emerging technologies are producing complex and intense social-policy concerns,then reviews in detail human reproductive technologies, and illustrates the significant consequences of technological innovations for political and legal concepts of rights and obligations. (Examples include recent cases involving torts for wrongful life.) He analyzes possible alterations in the moral and legal status of the fetus in light of apparent technological and social-policy trends and presents a paradigm of fetal rights that reflects these changes. A final case is made for a comprehensive assessment of reproductive technologies, as well as for the urgent need to refine concepts of human life that in the past have been taken for granted, but that now are being challenged.

This book focuses on the public policy and political dimensions of Alzheimer's Disease and other dementias (AD/D) in the United States, with coverage of the global dimensions and relevant examples from other countries. Starting off with a discussion on the characteristics of AD/D and competing theories of their causes, their human and financial costs, and the increasing burden they place on all societies as populations age, the book examines in detail the range of policy issues they raise. These include funding policies, payment policy and regulatory functions, long-term services and support (LTCS), public health and prevention policies. The book analyses the big business surrounding AD/D and shows that the strong public fear of developing dementia heightens the likelihood of exploitation of vulnerable people looking for a technological fix. It examines both informal and formal caregivers and the heavy burden placed on families, primarily women, and recent policy attempts to strengthen LTCS. It also examines the latest evidence of potential risk-reduction and prevention strategies and the difficult issues surrounding advance directives, assisted suicide, and definitions of death that increasingly face policy makers. It concludes by analyzing the policy implications on possible technological scenarios.

In April 1982, an infant boy was born in Bloomington, Indiana, with Down syndrome and a defective, but surgically correctable, esophagus. His parents refused to consent to surgery or intravenous feeding. The hospital unsuccessfully sought a court order to force treatment, and appeals to higher courts also failed. The child, identified as Baby Doe by the news media, subsequently died. The events in Bloomington became the catalyst for action by the Reagan administration, the courts, and Congress that culminated in a federal policy that makes failure to treat newborns with disabilities a form of child neglect. This book centers on the public policy aspects of withholding treatment from critically ill newborns who are disabled. Specifically, it deals with why the policy was enacted and what impact it has had on health care workers, families, and infants. Some of the contributors to this book spearheaded the early debate on withholding treatment. Anthony Shaw's New York Times Magazine article in 1972 was the first to address these issues in the popular press. The following year, he published a related article in the New England Journal of Medicine. Also appearing in this same issue of NEJM, was the pathbreaking study, coauthored by A. G. M. Campbell, on withholding treatment in the special care nursery at Yale-New Haven Hospital. Each of these articles promoted much public and professional discussion.

This book focuses on the public policy and political/ethical dimensions of ALS/MND across a wide selection of countries and argues for the need of a multidisciplinary and international approach. Policy issues addressed include adequacy of funding for research and care, payment policy and regulatory functions of public and private insurers, long-term services and caregiver support, public health and prevention efforts, access to genetic testing and assisted technologies, ensuring a competent and adequate workforce especially for hands-on caregivers, and the challenging issues of providing palliative and hospice care for ALS/MND patients, advance directives and assisted suicide that face policy makers in all political jurisdictions.

Considering dilemmas in medical policy making, Blank contends that there is only one way to improve health policy: by moderating public expectations of biomedical technologies and emphasizing preventive health care. Blank traces four aspects of health care: organ transplantation, the treatment of seriously ill newborns, reproductive technologies, and fetal health.

A broad-ranging introduction to the provision, funding and governance of health care across a variety of systems. This revised fifth edition incorporates additional material on low/middle income countries, as well as broadened coverage relating to healthcare outside of hospitals and the ever-increasing diversity of the healthcare workforce today.

How can America become a healthy nation, Blank asks, when it is beset by poverty, illiteracy, and crime? No new health care system can succeed unless or until the links between social problems and sickness are understood-and addressed. On the national level, Blank calls for a more aggressive redistribution of social and public health resources to the poor and elderly; at the same time, he describes sanctions that would encourage individuals to be more careful about their own health, and limit or change destructive behavior.

Blank and Merrick argue that medical advances, changing social values, and novel legal cases challenging conventional notions of reproductive rights, raising questions and creating difficult policy dilemmas.

This volume focuses on the conflicts surrounding reproduction and reproductive rights. Restricted access to abortion, rights of surrogate and biological mothers, the right to control fertility, fetal and embryo research, and a pregnant woman's duty to avoid risk are among the timely issues explored in this book. Conflicts in the maternal-fetal relationship, such as court-ordered intervention, maternal substance abuse, and workplace hazards are also covered.

This volume focuses on issues involving the inviolability of the human body and the decision to end life. The contributors explore the difficulties in framing a public policy that legalizes aid in dying, and return to the more general question of what is the most fair and effective relationship between private medical authority and public policy. In Part 1, biologists, ethicists, theologians and political scientists examine the issue of whether there ought to be limits to medical intervention. Although medicine has continually stretched the boundaries of intervention in the human body, new technologies of organ transplantation and genetics and the emergence of revolutionary drugs raise ethical concerns over how far we should go in moving from therapeutics to enhancement of the human body. Questions of inviolability also arise in situations where treatment of the foetus requires intrusion into the bodily integrity of the pregnant woman. The contributors debate what is meant by inviolability and where, if ever, it should be a matter of public policy. Part 2 brings together authors from bioethics, medicine, psychology, journalism and politics to examine the intensifying debate over the empowerment of patients in making decisions to end life.