Business ethics

Further information: Health economics

Balancing the cost of care with the quality of care is a major issue in healthcare philosophy. In Canadaand some parts ofEurope, democratic governments play a major role in determining how much public money from taxation should be directed towards the healthcare process. In the United States and other parts of Europe, private health insurance corporations as well as government agencies are the agents in this precarious life-and-death balancing act. According to medical ethicist Leonard J. Weber, "Good-quality healthcare means cost-effective healthcare," but "more expensive healthcare does not mean higher-quality healthcare" and "certain minimum standards of quality must be met for all patients" regardless of health insurance status.^[8]This statement undoubtedly reflects the varying thought processes going into the bigger picture of a healthcarecost-benefit analysis. In order to streamline this tedious process, health maintenance organizations (HMOs) likeBlueCross BlueShieldemploy large numbers ofactuaries(colloquially known as "insurance adjusters") to ascertain the appropriate balance between cost, quality, and necessity in a patient's healthcare plan.^[9]A general rule in the health insurance industry is as follows:

The least costly treatment should be provided unless there is substantial evidence that a more costly intervention is likely to yield a superior outcome.^[10]

This generalized rule for healthcare institutions "is perhaps one of the best expressions of the practical meaning of stewardshipof resources," especially since "the burden of proof is on justifying the more expensive intervention, not the less expensive one, when different acceptable treatment options exist."^[10]And lastly,frivolous lawsuitshave been cited as major precipitants of increasing healthcare costs.^[11]

Political philosophy of healthcare

Further information: Health care politics

In the political philosophyof healthcare, the debate betweenuniversal healthcareandprivate healthcareis particularly contentious in theUnited States. In the 1960s, there was a plethora of public initiatives by the federal government to consolidate and modernize the U.S. healthcare system. WithLyndon Johnson'sGreat Society, the U.S. established public health insurance for both senior citizens and the underprivileged. Known as Medicare and Medicaid, these two healthcare programs granted certain groups of Americans access to adequate healthcare services. Although these healthcare programs were a giant step in the direction ofsocialized medicine, many people think that the U.S. needs to do more for its citizenry with respect to healthcare coverage.^[12]Opponents of universal healthcare see it as an erosion of the high quality of care that already exists in the United States.^[13]

U.S. Medicare (2008)

Patients' Bill of Rights

Further information: U.S. Patients' Bill of Rights

In 2001, the U.S. federal government took up an initiative to provide patients with an explicit list of rights concerning their healthcare. The political philosophy behind such an initiative essentially blended ideas of the Consumers' Bill of Rightswith the field of healthcare. It was undertaken in an effort to ensure the quality of care of all patients by preserving the integrity of the processes that occur in the healthcare industry.^[14]Standardizing the nature of healthcare institutions in this manner proved provocative. In fact, manyinterest groups, including theAmerican Medical Association(AMA) andBig Pharmacame out against the congressional bill. Basically, having hospitals provide emergency medical care to anyone, regardless ofhealth insurancestatus, as well as the right of a patient to hold their health plan accountable for any and all harm done proved to be the two biggest stumbling blocks for the bill.^[14]As a result of this intense opposition, the initiative eventually failed to passCongressin 2002.