Private Health Care System

How can decisions about health care in the United States - too long dominated by providers, government, and the legal system - be put back into the hands of the people? Clark C. Havighurst contends that private contracts can be sharpened to do just that and ensure universal coverage, too. Private contracts, the author states, would allow for more and genuine consumer choice, based on real differences among competing health plans in content, coverage, and cost of services. Contracts would establish the standards and obligations of all parties - instead of the courts relying on definitions of care borrowed from the medical profession that drive health plans to overspending. Voluntary economizing would replace rationing without consent. Contracts could cure a dysfunctional health care market and end a severe misuse of U.S. resources. Often with specific contract language, Mr. Havighurst offers organized health plans, employers, purchasing cooperatives, Congress, and the courts ways they can turn private contracts into effective instruments of consumer-driven health reform. He recommends explicit recognition of contracts in any health reform legislation. With changes in how health coverage is purchased, courts would respect freedom of contract. And better health care contracts could be the key to designing an appropriate and affordable form of universal coverage.

In many countries of the world, including Canada, arguments are made for a private-public mix in the financing and provision of health services. Proponents claim that such a mix would improve both access and quality of health care. Opponents counter that it would create a two-tiered system, narrowing the range of options available to the lower socioeconomic segments of society and ultimately harming the equitable delivery of quality health care. This book presents empirical evidence on this contentious and highly politicized issue. Uniquely, it integrates qualitative and quantitative analyses of health care reforms at various stages of implementation in three countries of Latin America. The book sheds light on important issues pertaining to accessibility and equity and, in its approach, sets precedents and provides guidelines for further comparative work on health care reform. "Reshaping Health Care" in Latin America will appeal to academics, scholars, researchers, and students in health sciences, policy studies, Latin American studies, and international development. It will also be of interest to health practitioners, policymakers, and all citizens who follow the continuing international debate on the private-public mix in our health care systems.