The rapidly increasing numbers of elderly people in our society have raised some important moral questions: How should we distribute social resources among different age groups? What does justice require from both the young and the old? In this book, Norman Daniels offers the first systematic philosophical discussion of these urgent questions, advocating what he calls a "lifespan" approach to the problem: Since, as they age, people pass through a variety of institutions, the challenge of caring for the elderly becomes the prudent allocation of public resources among the various stages of people's lives. Using this philosophical approach, Daniels addresses specific public policy issues such as the allocation of medical funds, the adequacy of long-term care, current Medicare cost-containment measures, and the equitable distribution of income support over the lifespan and between generations.

Am I My Parents' Keeper?: An Essay on Justice Between the Young and the Old

Politics & Social Sciences

Daniels, Norman

Philosophy

Oxford University Press

In today's society, the young and the old compete fiercely for an essential yet scarce resource--public funds for human services. With the rapidly increasing number of people over the age of sixty-five, we face a wide range of new dilemmas, including how to distribute social resources among the different age groups competing for them, and how to determine the exact relationship between filial obligations and social obligations to care for the elderly. In Am I My Parents' Keeper?, Norman Daniels seeks a principled way, rooted in a theory of justice, to resolve disputes about how to allocate income support, health care, and other such resources to different age groups in our society. Daniels argues that since all people age, we all pass through institutions which distribute social goods over the whole lifespan. If we can determine what to give ourselves at each stage of life, we can discover what justice requires between age groups. This first systematic discussion of the problems of distributive justice which arise between the young and the old offers refreshingly innovative ideas and a unified perspective on the subject.

Sociology

This book addresses probing questions by translating the general moral concept of fairness into specific criteria for measuring the fairness of proposals for health reform. The authors demonstrate how concerned members of the public and policy makers can apply their benchmarks by actually scoring four major proposals for health care reform exemplifying the most prevalent ideas of the 1990s. They pay particular attention to the moral foundation of reforms based on competition. Although some reform ideas fare better than others, all are found weak in establishing open, democratic procedures for deciding the limits of care. The book also appraises the changes caused by the rapid growth of managed care systems since the collapse of national reform. Written by a leading moral philosopher of health care, an internationally known sociologist, and a health economist, Benchmarks of Fairness should be read by citizens, physicians, nurses, employers, and politicians.

Benchmarks of Fairness for Health Care Reform

Medical Books

Light, Donald W.

Caplan, Ronald L.

Administration & Medicine Economics

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.

Setting Limits Fairly: Can We Learn to Share Medical Resources?

Sabin, James

The central idea behind this book is that we lack consensus on principles for allocating medical resources -- and in the absence of such a consensus we must develop and rely on a fair decision-making process for setting limits on health care. Daniels and Sabin provide a cogent analysis of the current situation, lucidly review the usual candidate solutions, and describe their own approach. The audience for the book is global since the problem of limited resources cuts across types of health care systems whether or not they have universal coverage. In its first edition the book stimulated considerable work on setting priorities in health care, both here and abroad. The revision adds new material to the book, including several chapters by Daniels on new international research data from Mexico and Canada, and a new chapter on managing pharmacy benefits. Having the book available in paperback will also extends its influence, particularly as the topic grows in importance.

Sabin, James E.

The central idea behind this book is that we lack consensus on principles for allocating medical resources -- and in the absence of such a consensus we must develop and rely on a fair decision-making process for setting limits on health care. Daniels and Sabin provide a cogent analysis of the current situation, lucidly review the usual candidate solutions, and describe their own approach. The audience for the book is global since the problem of limited resources cuts across types of health care systems whether or not they have universal coverage. In its first edition the book stimulated considerable work on setting priorities in health care, both here and abroad. The revision adds new material to the book, including several chapters by Daniels on new international research data from Mexico and Canada, and a new chapter on managing pharmacy benefits. Having the book available in paperback will also extends its influence, particularly as the topic grows in importance.

Setting Limits Fairly: Learning to Share Resources for Health

Business & Money

Economics

Meet the Smiths (Smith family)

BERKLEY

Chase

Berkley Publishing Corp.

Wyndward Passion

WARNER BOOKS

Wyndward Fury

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