Managing Care: A Shared Responsibility
The goal of this book is to propose an alternative approach to address the problem of the exponential rise of health care costs, and, more importantly, to address the lingering dilemma of how to establish broadly agreed-upon fundamental guidelines by which health care can be managed in a manner that is more morally appropriate. Although in no way a new concept, the notion that society’s financial resources, even when it comes to health care, are indeed limited is one with which the general public has grown increasingly familiar only during the past two decades. Familiarity, however, does not automatically imply public appreciation for the strategies that have been implemented to curb the problems of health care. These strategies have customarily been designed to change the distribution of health care, such as by limiting patient choices, reducing access, lowering utilization, increasing premiums, requiring higher deductibles, or shifting financial responsibilities. In other words, the main focus has been on making the patient, or as the commodity market would say, the consumer, more responsible.
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The Concept of Genuine Responsibility
The Notion of Responsibility
Revising the Template for Modeling Health Care
Justice as Appropriation
The Context of Scarcity and Its Ideological Impact
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access to health agency theory argument asymmetric relations basic business organizations choices claim clinical concept of genuine considered context corporate cost of health cost-benefit analysis cost-effectiveness covenantal debate defined delivery discussion distributive decision dominant economic Emanuel employees entitlement ethics evidence-based medicine for-profit free-market genuine responsibility goals health care costs health care distribution health care insurance health care reform health care services health care system health insurance health plan human ideology increased individual industry interests issues justice as appropriation legitimacy legitimate libertarian limbic system limited MCOs medical services Medicare medicine moral agents moral community neocortex normative notion of responsibility obligation organization’s outcomes paradigm of responsibility parties patients percent perspective physicians practice premise principle of genuine priority problems profit providers question rationing reasons requires result role scarcity social society stakeholders strategies theory of justice validity