For-Profit Enterprise in Health Care

For-Profit Enterprise in Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1986-01-01

Total Pages: 580

ISBN-13: 0309036437

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"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.


Medicine, Money, and Morals

Medicine, Money, and Morals

Author: Marc A. Rodwin

Publisher: Oxford University Press

Published: 1995-04-20

Total Pages: 432

ISBN-13: 0198024266

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Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.


Medicine and Money

Medicine and Money

Author: Frank H. Marsh

Publisher: Praeger

Published: 1990-06-11

Total Pages: 0

ISBN-13: 0313263574

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Medicine and Money: A Study of the Role of Beneficence in Health Care Cost Containment is a frank discussion of the moral problems associated with the need to control health care costs. The book provides a base for physicians to address these concerns and examines the events leading to America's current health care crisis, diminishing beneficence. After a brief definition of the problem, Frank H. Marsh and Mark Yarborough continue by describing the threat of cost containment and justifying beneficence-based health care system. Special importance is given to Medicine and Money by the lengthy suggestions on implementing beneficence in the health care system. Marsh and Yarborough address the problem of eroding morality and rising cost concerns of our present health care system. They argue that if the central role of beneficence is abandoned, the medical profession will be unable to properly meet the challenge it faces. Medicine and Money divides its argument into two sections. In the first section, the current crisis in health care is examined and a justification for beneficence is given. The second section describes how beneficence can be implemented in the health care system as a means to control health care costs. Medicine and Money is written for every member of the medical and philosophical communities.


What Money Can't Buy

What Money Can't Buy

Author: Michael J. Sandel

Publisher: Farrar, Straus and Giroux

Published: 2012-04-24

Total Pages: 256

ISBN-13: 1429942584

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Should we pay children to read books or to get good grades? Should we allow corporations to pay for the right to pollute the atmosphere? Is it ethical to pay people to test risky new drugs or to donate their organs? What about hiring mercenaries to fight our wars? Auctioning admission to elite universities? Selling citizenship to immigrants willing to pay? In What Money Can't Buy, Michael J. Sandel takes on one of the biggest ethical questions of our time: Is there something wrong with a world in which everything is for sale? If so, how can we prevent market values from reaching into spheres of life where they don't belong? What are the moral limits of markets? In recent decades, market values have crowded out nonmarket norms in almost every aspect of life—medicine, education, government, law, art, sports, even family life and personal relations. Without quite realizing it, Sandel argues, we have drifted from having a market economy to being a market society. Is this where we want to be?In his New York Times bestseller Justice, Sandel showed himself to be a master at illuminating, with clarity and verve, the hard moral questions we confront in our everyday lives. Now, in What Money Can't Buy, he provokes an essential discussion that we, in our market-driven age, need to have: What is the proper role of markets in a democratic society—and how can we protect the moral and civic goods that markets don't honor and that money can't buy?


The Price of Health

The Price of Health

Author: G.J. Agich

Publisher: Springer

Published: 2011-11-22

Total Pages: 280

ISBN-13: 9789401085922

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Medicine, morals and money have, for centuries, lived in uneasy cohabitation. Dwelling in the social institution of care of the sick, each needs the other, yet each is embarrassed to admit the other's presence. Morality, in particular, suffers embarrassment, for it is often required to explain how money and medicine are not inimical. Throughout the history of Western medicine, morality's explanations have been con sistently ambiguous. Pla.o held that the physician must cultivate the art of getting paid as well as the art of healing, for even if the goal of medicine is healing and not making money, the self-interest of the craftsman is satisfied thereby [4]. Centuries later, a medieval medical moralist, Henri de Mandeville, said: "The chief object of the patient ... is to get cured ... the object of the surgeon, on the other hand, is to obtain his money ... ([5], p. 16). This incompatibility, while general, is not universal. Throughout history, medical practitioners have resolved the problem - either in conscience or to their satisfaction. Some physicians have been so reluctant to make a profit from the ills of those whom they treated that they preferred to live in poverty. Samuel Johnson described his friend, Dr. Robert Levet, a Practiser of Physic: No summons mock'd by chill delay, No petty gain disdain'd by pride; The modest wants of ev'ry day The toil of ev'ry day supplied [3].


Balancing Act

Balancing Act

Author: E. Haavi Morreim

Publisher: Springer

Published: 2013-10-03

Total Pages: 0

ISBN-13: 9789401737432

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Medicine's changing economics have already fundamentally, permanently altered the relationship between physician and patient, E. Haavi Morreim argues. Physicians must weigh a patient's interests against the legitimate, competing claims of other patients, of payers, of society as a whole, and sometimes even of the physician himself. Focusing on actual situations in the clinical setting, Morreim explores the complex moral problems that current economic realities pose for the practicing physician. She redefines the moral obligations of both physicians and patients, traces the specific effects of these redefined obligations on clinical practice, and explores the implications for patients as individuals and for national health policy. Although the book focuses on health care in the United States, physicians everywhere are likely to face many of the same basic issues of clinical ethics, because every system of health care financing and distribution today is constrained by finite resources.


The Ethics of Health Care Rationing: An Introduction

The Ethics of Health Care Rationing: An Introduction

Author: Greg Bognar

Publisher: Routledge

Published: 2014-06-05

Total Pages: 180

ISBN-13: 1317695887

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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.


China: Bioethics, Trust, and the Challenge of the Market

China: Bioethics, Trust, and the Challenge of the Market

Author: J. Tao Lai Po-wah

Publisher: Springer Science & Business Media

Published: 2008-07-08

Total Pages: 212

ISBN-13: 1402067577

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to the Moral Challenges H. Tristram Engelhardt, Jr. and Aaron E. Hinkley 1 Taking Finitude Seriously in a Chinese Cultural Context Across the world, health care policy is a moral and political challenge. Few want to die young or to suffer, yet not all the money in the world can deliver physical immortality or a life free of suffering. In addition, health care needs differ. As a result, unless a state coercively forbids those with the desire and means to buy better basic health care to do so, access to medicine will be unequal. No co- try can afford to provide all with the best of care. In countries such as China, there are in addition stark regional differences in the quality and availability of health care, posing additional challenges to public policy-making. Further, in China as elsewhere, the desire to lower morbidity and mortality risks has led to ever more resources being invested in health care. When such investment is supported primarily by funds derived from taxation, an increasing burden is placed on a country’s economy. This is particularly the case as in China with its one-child policy, where the proportion of the elderly population consuming health care is rising. Thesepolicychallengesarecompoundedbymoraldiversity. Defacto,humansdo not share one morality. Instead, they rank cardinal human goods and right-making conditions in different orders, often not sharing an af?rmation of the same goods or views of the right.