Health care services are rapidly changing in ways that seem increasingly inaccessible and unfair to millions of Americans. Yet what does "unfair" mean and how should our system be changed to make it more "fair"? This book addresses these probing questions by providing a universal definition of fairness and a set of criteria to measure which health care reform policies are more fair and why. The book comprises the efforts of a leading moral philosopher of health care, an internationally known sociologist of health care systems, and a health economist who join forces to transpose for the first time the universal moral concept. Through examples, they show how leaders and experts in various realms of public policy could develop criteria for applying concepts of moral philosophy to different fields. The book is original and controversial because it actually scores four major proposals for health care reform that exemplify the most prevalent ideas of the 1990s in state and national circles. Although some reform ideas fare much better than others, the author finds all proposals wanting, especially in establishing open, democratic procedures for deciding the limits of care. The authors give special attention to what market-based reforms need to do to be fair to everyone. They also assess the current changes brought on by the rapid growth of managed care systems since the collapse of national reform. Benchmarks of Fairness should be read by every citizen, physician, nurse, employer and politician who wants to educate themselves about fairness and who is interested in assessing the fairness of health care reforms.
