The central idea for this book is that we lack consensus on principles for allocating resources and in the absence of such a consensus we must rely on a fair decision-making process for setting limits on health care. The authors characterize key elements of this process in a variety of health care contexts where such decisions are made- decisions about insurance coverage for new technologies, pharmacy benefit management, the design of physician incentives, contracting for mental health care by public agencies, etc.- and they connect the problem in the U.S. with the same problem in other countries. They provide a cogent analysis of the current situation, lucidly review the usual candidate solutions, and describe their own approach, which represents a clear advance in thinking. Their intended audience is international since the problem of limits cuts across types of health care systems whether or not they have universal coverage.

Contenuti

1: Our Lives in Whose Hands?
2: Justice, Scarcity, and Public Accountability for Limits
3: The Legitimacy Problem and Fair Process
4: Accountability for Reasonableness
5: Managing Last-Chance Therapies
6: Lung Volume Reduction Surgery: A Case Study
7: Making Pharmacy Benefits Accountable for Reasonableness
8: Indirect Limit Setting: Accountability for Physician Incentives
9: Accountability for Reasonableness in Action: Public Sector Contracting for Mental Health Care
10: An International Learning Curve
11: Learning to Share Medical Resources

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