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In one form or another, health care now gets rationed. Not everything beneficial is done for every patient. For the individual the consequences are sometimes tragic. Rationing decisions thus raise a classic dilemma: how can we treat with dignity and genuine respect the person who gets short-changed ...

In one form or another, health care now gets rationed. Not everything beneficial is done for every patient. For the individual the consequences are sometimes tragic. Rationing decisions thus raise a classic dilemma: how can we treat with dignity and genuine respect the person who gets short-changed by an efficient policy that seems best overall? Strong Medicine argues that we can, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients as well as the doctor ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperiled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers interested in policy questions the book takes up. The issues are fascinating, the arguments are careful, and the results often surprising.

This volume examines the two models of health care reform, managed competition and internal markets, that are increasingly becoming the dominant paradigm in European and North American policy by considering the experience of reform in the U.S., Canada, the U.K, the Netherlands and New Zealand, the ...

This volume examines the two models of health care reform, managed competition and internal markets, that are increasingly becoming the dominant paradigm in European and North American policy by considering the experience of reform in the U.S., Canada, the U.K, the Netherlands and New Zealand, the author analyzes which reform model is likely to efficiently ensure access for all citizens to a comprehensive range of services and draws out the implications for policy.