Making Medical Spending Decisions: The Law, Ethics, and Economics of Rationing Mechanisms / Edition 1

Making Medical Spending Decisions: The Law, Ethics, and Economics of Rationing Mechanisms / Edition 1

by Mark A. Hall
     
 

ISBN-10: 0195092198

ISBN-13: 9780195092196

Pub. Date: 12/28/1996

Publisher: Oxford University Press, USA

A fresh and comprehensive exploration of how health care rationing decisions are made, this book offers not specific criteria for rationing—like age or quality of life—but a comparative analysis of three alternative decision makers: consumers paying out of pocket, government and insurance officials setting limits on treatments and coverage, and

…  See more details below

Overview

A fresh and comprehensive exploration of how health care rationing decisions are made, this book offers not specific criteria for rationing—like age or quality of life—but a comparative analysis of three alternative decision makers: consumers paying out of pocket, government and insurance officials setting limits on treatments and coverage, and physicians making decisions at the bedside. Hall's analysis reveals that none of these alternatives is uniformly superior, and, therefore, a mix of all three is inevitable.
The author develops his analysis along three lines of reasoning: political economics, ethics, and law. The economic dimension addresses the practical feasibility of each method for making spending decisions. The ethical dimension discusses several theories—principally classic liberalism, social contract theory, and communitarianism—as well as concepts like autonomy and coercion. The legal dimension follows 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.

Read More

Product Details

ISBN-13:
9780195092196
Publisher:
Oxford University Press, USA
Publication date:
12/28/1996
Edition description:
New Edition
Pages:
312
Product dimensions:
6.37(w) x 9.50(h) x 1.12(d)

Related Subjects

Table of Contents

I. Introduction: Who Decides?
The Inevitability of Medical Spending Decisions
Asking the Right Questions
The Plan of this Book
II. Patient Spending Decisions
The Case in Favor of Market Reforms
Increasing Patient Sensitivity to Medical Costs
The Case Against Patient Cost-Sharing
Conclusion
III. Third-Party Rules
Bureaucratic and Legalistic Mechanisms
Technocratic Resource Allocation and the Emerging Role of Science
The Flaws of Rule-Based Rationing
Ideal Democratic Processes
Physician Overseers
IV. Physician Bedside Discretion
Opposition to Physician Bedside Rationing
The Nature and Extent of Bedside Rationing
The Moral and Political Status of Mainstream Medical Ethics
Beneficence and Autonomy
Conclusion and Further Inquiries
Appendix
V. Motivating Physicians With Financial Incentives
Fiduciary Law
Agency Cost Theory
VI. Informed Consent to Rationing
Disclosing Rationing Mechanisms During Insurance Enrollment
Disclosure at the Time of Treatment
A Theory of Economic Informed Consent
Conclusion
VII. Conclusion: Deciding Who Decides
Comparing Decision Makers
Choosing Decision Makers
The Political Morality of Insurance Selection
Bibliography
Index

Read More

Customer Reviews

Average Review:

Write a Review

and post it to your social network

     

Most Helpful Customer Reviews

See all customer reviews >