Ethical Challenges in Managed Care

One of the most interesting areas of the current managed care debate is one that receives far too little attention: that is the ethical dimension. This book has gone a long way to fill this gap, especially when it comes to help clarify lines of responsibility and accountability. This is an important and powerful book. -- U.S. Senator Paul Wellstone

The rapid rise of managed care in the United States has introduced complexities into ethical dilemmas in health care by changing the traditional relationships among health plans, payers, providers, and patients. This book explores the goals, methods, and practices of managed care.The rapid rise of managed care in the United States has introduced new complexities into ethical dilemmas in health care by changing the traditional relationships among health plans, payers, providers, and patients. Through twenty case studies that provide snapshots of a wide range of ethical challenges, this book explores the goals, methods, and practices of managed care. Accompanying each case are questions for consideration and a pair of commentaries by prominent contributors from diverse fields. Through the cases and commentaries, this book clarifies the internal workings of managed care, explains relevant concepts, and offers practical, constructive guidance in addressing the ethical and policy issues. The cases address a broad spectrum of issues concerning rationing shared resources, financial incentives, quality of care, and responsibilities to patients, vulnerable populations, and the community. Specific topics range from coverage of emergency services through funding medical education to respecting patients' religious beliefs and caring for the seriously mentally ill. This casebook offers a wealth of insights into critical issues that affect the delivery of managed care in an increasingly competitive market. It will be invaluable for those managing the delivery and financing of health care and for students and practitioners of the health professions and health administration, as well as interested recipients of managed care.