E. Haavi Morreim - Balancing Act: The New Medical Ethics of Medicines New Economics (Clinical Medical Ethics Series)

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title	:	Balancing Act : The New Medical Ethics of Medicine's New Economics Clinical Medical Ethics (Washington, D.C.)
author	:	Morreim, E. Haavi.
publisher	:	Georgetown University Press
isbn10 | asin	:	0878405844
print isbn13	:	9780878405848
ebook isbn13	:	9780585211091
language	:	English
subject	Medical care--Cost control--Moral and ethical aspects, Managed care plans (Medical care)--Moral and ethical aspects, Health care rationing--Moral and ethical aspects, Physician and patient.
publication date	:	1995
lcc	:	RA410.5.M667 1995eb
ddc	:	174/.26
subject	:	Medical care--Cost control--Moral and ethical aspects, Managed care plans (Medical care)--Moral and ethical aspects, Health care rationing--Moral and ethical aspects, Physician and patient.

Balancing Act The New Medical Ethics of Medicine's New Economics

Page ii Clinical Medical Ethics Editors H. Tristram Engelhardt, Jr., The Center for Ethics, Medicine and Public Issues, Baylor College of Medicine, Houston, Texas Kevin Wildes, S.J., Department of Philosophy, Georgetown University, Washington, D.C. Editorial Advisory Board George J. Agich, School of Medicine, Southern Illinois University Springfield, Illinois Dan W. Brock, Department of Philosophy, Brown University, Providence, Rhode Island Baruch A. Brody, Center for Ethics, Medicine and Public Issues, Baylor College of Medicine, Houston, Texas Allen E. Buchanan, School of Medicine, University of Wisconsin at Madison, Madison, Wisconsin Antonio M. Gotto, Jr. Department of Medicine, Baylor College of Medicine, Houston, Texas Angela R. Holder, School of Medicine, Yale University, New Haven, Connecticut Jay Katz, Yale Law School, Yale University, New Haven, Connecticut Loretta M. Kopelman, Department of Medical Humanities, School of Medicine, East Carolina University, Greenville, North Carolina Edmund D. Pellegrino, Director, Center for Clinical Bioethics, Georgetown University, Washington, D.C. Stephen Wear, Department of Philosophy, State University of New York at Buffalo, Buffalo, New York Previous Books in the Series Competence to Consent Becky White

Page iii Balancing Act The New Medical Ethics of Medicine's New Economics E. Haavi Morreim Georgetown University Press / Washington, D.C.

Page iv To Florence and Paul, my mother and father, with all my love. Georgetown University Press, Washington, D.C. 1995 by Georgetown University Press. All rights reserved. Printed in the United States of America 10 9 8 7 6 5 4 3 2 1995 This volume is printed on acid-free offset book paper Library of Congress Cataloging-in-Publication Data Morreim, E. Haavi. Balancing act : the new medical ethics of medicine's new economics / E. Haavi Morreim. p. cm. Includes bibliographical references and index. 1. Medical careCost controlMoral and ethical aspects. 2. Managed care plans (Medical care)Moral and ethical aspects. 3. Health care rationingMoral and ethical aspects. 4. Physician and patient. I. Title. RA410.5.M667 1995 174.26dc20 ISBN 0-87840-584-494-37058

Page v Contents Acknowledgments vii Notice viii 1 Overview 1 Notes 6 2 A Bit of History 8 Sources of Cost Escalation 9 Early Efforts at Cost Containment 13 Future Economic Pressures 15 Notes 17 3 Economic Forces, Clinical Constraints 21 Broad Economic Forces 21

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