Solidarity, Responsibility, and Freedom: Health Care Reform in the United States at the Millennium

Dissertation, Rice University (2003)

Abstract
The current crisis in the distribution of health care resources in the U.S. derives largely from insufficient access to health care, on the one hand, and inadequate control of rising costs, on the other hand. The response to the problem of insufficient access should not be the recognition of a moral right to health care but rather the establishment of a legal right to health care for all. In turn, the contours of this legal right can be the means to create the needed cost controls. To this end, they should include a laundry list of covered condition-treatment pairs, which would be informed by the measuring stick of quality-adjusted-lifeyears, and which would be the product of input from the public, the medical profession, and the Congress. The resultant structure of universal coverage, under a system of explicit rationing, would include a morally mandated second tier. Universal coverage, explicit rationing, and a second tier are the indispensable building blocks of meaningful health care reform in the U.S
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