Managed Health Care: New Ethical Issues for All

Abstract

Changes in the way that health care is perceived, delivered, and financed have occurred rapidly in a relatively short time span. The 50-year period since World War II encompasses enormous growth in medical technology, soaring health care costs, and significant fragmentation of the two-party patient-physician relationship. This relationship first grew to include the third-party payer, the health insurance industry, and now "with great speed and relatively little awareness, a significant change has occurred in the way some decisions are made about a patient's medical care" (III, Institute of Medicine 1989).