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The case for managed care: reappraising medical and socio-political ideals.

Authors
  • Khushf, G
Type
Published Article
Journal
The Journal of medicine and philosophy
Publication Date
Oct 01, 1999
Volume
24
Issue
5
Pages
415–433
Identifiers
PMID: 10614730
Source
Medline
Keywords
License
Unknown

Abstract

The arguments against managed care can be divided into two general clusters. One cluster concerns the way managed care undermines the ethical ideals of medical professionalism. Since those ideals largely focus on the physician-patient relation, the first cluster comes under the rubric of micro-ethics; namely, the ethics of individual-individual relations. The second cluster of criticisms focuses on macro-ethical issues, primarily on issues of justice and policy. By reviewing these arguments, it becomes clear that managed care does not easily fit within traditional modes of ethical analysis. It poses a radical challenge to current medical and socio-political norms, and even resists the distinction between micro- and macro-ethical domains, a distinction that reflects the private/public distinction. Managed care organizations call for a third way, an inter-ethic for middle level organizations. The essays in this Journal provide a first step in this radical reassessment, laying the foundation for an organizational ethic that is responsive to the realities and promise of managed care.

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