Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical students.

The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health.

The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless.

Arguing that health care should be a human right rather than a commodity, the distinguished contributors to this volume call for a new social covenant establishing a right to a standard of health care consistent with society's level of resources. By linking rights with limits, they offer a framework for seeking national consensus on a cost-conscious standard of universal medical care. The authors identify the policy implications of recognizing and implementing such a right and develop specific criteria to measure the success of health care reform from a human rights perspective.

Health Care Reform also offers specific and timely criticism of managed competition and its offspring, the Clinton plan for health care reform. Because health care reform will inevitably be an ongoing process of assessment and revision—especially since managed competition has not been implemented elsewhere—this book will last beyond the moment by providing vital standards to guide the future evolution of the health care system.

"Dan Beauchamp's important book melds a personal odyssey, an abiding, passionate commitment to one version of comprehensive health reform, and highly disciplined political analysis. His years in the Cuomo Administration provide him with rich insight into how that scion of liberalism inched toward, but ultimately shied away from, major health reform in the Empire State. His provocative assessment of the missed opportunities represented by the Clinton health plan also deserves the attention of any serious student of health politics and policy." --Frank J. Thompson, Professor of Dean, Graduate School of Public Affairs, State University of New York at Albany While most studies of health care reform have focused on solving the market's failure, controlling costs, or providing universal access, Dan E. Beauchamp adeptly discusses health care reform as a strategy for dealing with the failures of politics--not just the failures of the health care market. As the former Deputy Commissioner for Policy and Planning for the New York State Department of Health, Beauchamp presents a revelatory first-person narrative about his work to develop a universal health care and insurance plan for New York State. His enlightening personal account includes discussions of his efforts to develop a national model of the New York plan for Mario Cuomo (during the period when the governor considered running for the Democratic nomination for president), and his perceptive critique of the failed Clinton plan for reform. Beauchamp gets beyond topics like global budgets, rate-setting, and managed competition to outline the idea of health plans as a means for the public to come together in a way that will change forever the way we think about health care, which he calls "the battle for the body politic." A large part of engaging in the "battle," he argues, involves addressing and resolving racial and class divisions that have always underscored America's political reality. Ultimately, Beauchamp argues for a reform that would promote health and social equality, one that would change and strengthen our social awareness of health care as a common good. "Dan Beauchamp is a singular and important voice in the ongoing health care debate. Instead of focusing on the technical details of health reform, he spins a compelling personal narrative, entices the reader into the truly important questions: How do health plans work politically? How can they change the way we think about health, health care and ourselves as a country? While economists focus on financing schemes, and bioethicists search for underlying values, Beauchamp probes how a health care system shapes our politics and affects our experience of who we are as Americans. His book is exceedingly valuable; it reveals just how much is at stake in health care reform." --Larry R. Churchill, Professor and Chair, Department of Social Medicine, University of North Carolina at Chapel Hill

Medicine, Health Care, and Ethics adds to this rich tradition with a collection of contemporary essays that represent the very best efforts of current Catholic scholarship in the field of health care and medical ethics.