Tailor-made finance versus tailor-made care. Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care?
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 36 (2):79-83 (2010)
Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Ho Mun Chan & Sam Pang (2007). Long-Term Care: Dignity, Autonomy, Family Integrity, and Social Sustainability: The Hong Kong Experience. Journal of Medicine and Philosophy 32 (5):401 – 424.
George J. Agich (1993). Autonomy and Long-Term Care. Oxford University Press.
H. Tristram Engelhardt Jr (2007). Long-Term Care: The Family, Post-Modernity, and Conflicting Moral Life-Worlds. Journal of Medicine and Philosophy 32 (5):519 – 536.
Ruiping Fan (2007). Which Care? Whose Responsibility? And Why Family? A Confucian Account of Long-Term Care for the Elderly. Journal of Medicine and Philosophy 32 (5):495 – 517.
Kelly Oliver (2011). Deconstructing “Grown Versus Made”. Journal of Philosophy: A Cross-Disciplinary Inquiry 7 (16):42-52.
Xiaomei Zhai & Ren Zong Qiu (2007). Perceptions of Long-Term Care, Autonomy, and Dignity, by Residents, Family and Caregivers: The Beijing Experience. Journal of Medicine and Philosophy 32 (5):425 – 445.
Mark G. Kuczewski (1999). Ethics in Long-Term Care: Are the Principles Different? Theoretical Medicine and Bioethics 20 (1):15-29.
Madison Powers (1997). Managed Care: How Economic Incentive Reforms Went Wrong. Kennedy Institute of Ethics Journal 7 (4):353-360.
Chan Ho-mun (1999). Free Choice, Equity, and Care: The Moral Foundations of Health Care. Journal of Medicine and Philosophy 24 (6):624 – 637.
Linda M. Axtell-Thompson (2005). Consumer Directed Health Care: Ethical Limits to Choice and Responsibility. Journal of Medicine and Philosophy 30 (2):207 – 226.
Pythagoras Petratos (2005). Does the Private Finance Initiative Promote Innovation in Health Care? The Case of the British National Health Service. Journal of Medicine and Philosophy 30 (6):627 – 642.
David E. Weissman & Sandra Matson (1999). Pain Assessment and Management in the Long-Term Care Setting. Theoretical Medicine and Bioethics 20 (1):31-43.
K. I. Johannessen (2009). Justice in Care--With Special Regard to Long-Term Care. Christian Bioethics 15 (2):154-172.
Richard A. Epstein (1999). Managed Care Under Siege. Journal of Medicine and Philosophy 24 (5):434 – 460.
John H. Sorenson & Garrett E. Bergman (1984). Delineating Paternalism in Pediatric Care. Theoretical Medicine and Bioethics 5 (1).
Added to index2010-09-13
Total downloads7 ( #185,492 of 1,100,913 )
Recent downloads (6 months)3 ( #116,144 of 1,100,913 )
How can I increase my downloads?