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This inter-disciplinary volume gathers scholars from around the world to explore clinical, cultural and ethical perspectives on end-of-life care, not only for the dying but also for those who attend the dying as caregivers.
Includes proceedings of the association, papers read at the annual sessions, and lists of current medical literature.
This paper assesses the extent to which provider payment mechanisms can help developing countries address their leading health care problems. It first identifies four key problems in the health care systems in developing countries: 1) public facilities, which provide the bulk of secondary and tertiary health care services in most countries, offer services of poor quality; 2) providers cannot be enticed to rural and urban marginal areas, leaving large segments of the population without adequate access to health care; 3) the composition of health services offered and consumed is sub-optimal; and 4) coordination in the delivery of care, including referrals, second opinions, and teamwork, is inadequate. The paper examines each problem in turn and assesses the extent to which changes in provider payments might address it.
Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Egalitarianism, the view that equality matters, attracts a great deal of attention amongst contemporary political theorists. And yet it has turned out to be surprisingly difficult to provide a fully satisfactory egalitarian theory. The cutting-edge articles in Egalitarianism move the debate forward. They are written by some of the leading political philosophers in the field. Recent issues in the debate over equality are given careful consideration: the distinction between 'telic' and 'deontic' egalitarianism; prioritarianism and the so-called 'levelling down objection' to egalitarianism; whether egalitarian justice should have 'whole lives' or some subset thereof as its temporal focus; the implications of Scanlon's contractualist account of the value of choice for egalitarian justice; and the question of whether non-human animals fall within the scope of egalitarianism and if so, what the implications are. Numerous 'classic' issues receive a new treatment too: how egalitarianism can be justified and how, if at all, this value should be combined with other values such as desert, liberty and sufficiency; how to define the 'worst off' for the purposes of Rawls' difference principle; Elizabeth Anderson's feminist account of 'equality of relations'; how equality applies to risky choices and, in particular, whether it is justifiable to restrict the freedom of suppliers who wish to release goods that confer different levels of risk on consumers, depending on their ability to pay. Finally, the implications of egalitarianism and prioritarianism for health care are scrutinized. The contributors to the volume are: Richard Arneson, Linda Barclay, Thomas Christiano, Nils Holtug, Susan Hurley, Kasper Lippert-Rasmussen, Dennis McKerlie, Ingmar Persson, Bertil Tungodden, Peter Vallentyne, Andrew Williams, and Jonathan Wolff.
The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms public and private, and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, regionalization in the 1970s, or defining civil rights and equity as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional public role of the largely private medical profession. Section V returns to the ambiguous public-priv