American Health Care Realities, Rights, and Reforms [Hardcover]

Is our present health care system biased against people with limited education and income? Does every American have a moral right to health care? If so, what kinds of care and how much? In a provocative look at American health care delivery, Charles J. Dougherty considers these and many other questions. His book fills an important niche in contemporary medical ethics and public health literature by combining a description and analysis of the American health care system--as it actually operates today--with an assessment of recent philosophical writings on justice. In the first section, Dougherty describes inequalities in health care delivery to blacks, the poor, and the less educated. He then reviews the philosophical theories of utilitarianism, egalitarianism, contractarianism, and libertarianism; applies them to health care issues; and argues for a moral right to health care. He considers available policy alternatives, concluding that the empirical data and our understanding of justice and human rights should commit us to a national health care plan supported by national health insurance.

Part I: Realities
1. Some American Health Care Realities: Access to Needed Care; Quality of Care; Rising Costs
Part II: Rights
2. A Right to Health Care: The Concept of a Right; For and Against a Right to Health Care
3. Utilitarianism: Optimal Consequences; Prudent Insurance
4. Egalitarianism: Equal Intrinsic Value; Substantive Equality
5. Libertarianism: Liberty and Ownership; Compensatory Rights
6. Contractarianism: The Social Contract; Liberty, Opportunity, and Wealth
7. Plural Foundations: Proof and Persons; Four Health Care Rights; Rights, Clarity, and Ideals
Part III: Reforms
8. Market Reforms: Pure Competition; A Hobbled Market
9. DRGs, HMOs, and Vouchers: Price Controls; Prepaid Group Practice; Cash and Voucher Plans
10. National Health Care Plans: Medicare and Medicaid; NalcE