Social science & medicine
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Most economists have suggested that the growing presence of insurance, including Medicare, Medicaid, Blue Cross and the commercial insurers, is largely responsible for the rapid rise of health care costs in the United States. It is the contention of this paper, however, that the insurance industry in the private sector in the United States may help in the effort to contain costs rather than solely stimulating rapidly increasing costs. ⋯ It is cautioned, however, that although health insurer cost containment efforts will continue to expand in the future, perversities in the U. S. tax laws, potential provider opposition and the complexities of medicine will continue to make cost containment a difficult task.
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Social science & medicine · Jan 1982
Clinical Trial Historical ArticleHuman experimentation in historical and ethical perspectives.
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Social science & medicine · Jan 1982
The basis of privacy and autonomy in medical practice. A model.
Most of the medical literature concerned with privacy seems to be based on the implicit assumptions that there is such a thing as right-to-privacy and that privacy is a worthwhile end unto itself. This paper develops a model which should permit a better and more pragmatic understanding of the moral, ethical and psychosocial bases of these assumptions. Arguments are offered that privacy is, indeed, not mainly an intrinsic value but is more of an instrumental value. ⋯ The model is developed which states: the analogy of a person is as a unit consisting of a matrix which is unique and autonomous because of its separation from other units by means of a wall-of-privacy; the relationship between persons is measured by their social distance. Derived from this is the 'equation', A approximately equal to (P)(D). Intimacy, substitutive judgement, confidentiality and patient-physician relationship are conceptualized within this model.