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D. Eddy (1990)
Clinical decision making: from theory to practice. Connecting value and costs. Whom do we ask, and what do we ask them?JAMA, 264 13
D. Callahan (1991)
What Kind of Life: The Limits of Medical Progress
D. Eddy (1991)
Rationing by Patient ChoiceJAMA, 265
THE CONCEPT is very appealing. It postulates that there is a minimum set of services to which everyone should have access, regardless of ability to pay. This set of services would form a floor for insurance policies, health plans, and government programs. People who want to receive more services could purchase them, either by buying more comprehensive (and expensive) insurance policies or plans, or by paying out-of-pocket. But everyone would at least receive this basic level of care. In the concept of essential care we find a compromise between the idealistic view that Society should provide every-one with everything free of charge, and the practical fact that, as a society, we cannot pay the price of doing that. It strikes an ethical balance between Society's obligation to the individual and the individual's obligation to Society. The concept is indeed appealing. Unfortunately, putting the concept into practice is far more difficult.
JAMA – American Medical Association
Published: Feb 13, 1991
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