Ethical Foundations of the Clinton Administration's Proposed Health Care System
Brock, Dan W.
JAMA. 1994 April 20; 271(15): 1189-1196.
Important, widely shared ethical principles and values are involved in both the design of and the debates over the Clinton health care system reform proposal. In the first section of this article, we discuss 14 principles and values that guide policy decisions and choices about central features of the reform proposal. These principles and values are neither pulled from thin air nor selected simply to conform to the proposed system. They are deeply anchored in the moral traditions we share as a nation, reflecting our long-standing commitment to equality, justice, liberty, and community. Different moral, religious, and cultural traditions within our society may emphasize different elements of these principles and values or weigh them differently when they conflict. Nevertheless, there is a widespread consensus on their central role in defining our common community, as we show briefly in the second section of this article. These principles and values do not provide a precise blueprint for the design of a health care system, but they can guide our thinking about its essential features....In the third section of this article, we also discuss some important trade-offs involved in key choices about the design of the proposed system, as well as in changes in the proposed system that may result from the political effort to secure its passage, and show how the principles help illuminate what is at stake in these decisions....Our limited discussion is intended to highlight central issues and put them on the agenda of discussion in the debate about health care system reform.
Autonomy; Consensus; Costs and Benefits; Economics; Ethical Analysis; Federal Government; Financial Support; Freedom; Government; Health; Health Care; Health Care Reform; Health Insurance; Health Personnel; Incentives; Insurance; Justice; Managed Care Programs; Mental Health; Managed Care; Patient Care; Policy Analysis; Politics; Public Policy; Quality of Health Care; Resource Allocation; Risks and Benefits; State Government; Values;
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