The central idea for this book is that we lack consensus on principles for allocating resources and in the absence of such a consensus we must rely on a fair decision-making process for setting limits on health care. The authors characterize key elements of this process in a variety of health care contexts where such decisions are made- decisions about insurance coverage for new technologies, pharmacy benefit management, the design of physician incentives, contracting for mental health care by public agencies, etc.- and they connect the problem in the U.S. with the same problem in other countries. They provide a cogent analysis of the current situation, lucidly review the usual candidate solutions, and describe their own approach, which represents a clear advance in thinking. Their intended audience is international since the problem of limits cuts across types of health care systems whether or not they have universal coverage.

Setting Limits Fairly: Can We Learn to Share Medical Resources?

Politics & Social Sciences

Daniels, Norman

Sabin, James

Sociology

Oxford University Press

Can the ethical mission of health care survive among organizations competing for survival in the marketplace? On this question hinges not only the future of health care in the US, but that of the health care systems of all advanced countries. This book presents both an analytic framework and a menu of pragmatic answers. The team of authors, physician-ethicists from Harvard Medical School and the National Institutes of Health, worked with a consortium of health care organizations to explore some of the most challenging dilemmas in health care today: How can health plans determine medical necessity in a way that ensures quality care, controls costs, and builds trust with patients and physicians? What are the strategies for caring for vulnerable populations that meet their special neds without dramatically increasing costs? To answer these and other similar questions the authors blend ethical analysis with real-world example. The outcome is a rich analysis of the ethical challenges facing health care organizations, combined with tangible examples of exemplary methods to address these challenges. This book will help health care leaders, regulators, and policy makers incorporate exemplary practices, and the underlying themes they embody, into the very heart and soul of health care organizations.

No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence

Pearson, Steven D.

Emanuel, Ezekiel J.

Philosophy

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Books by Sabin, James