Disentitlement?: The Threats Facing Our Public Health Care Programs and a Right-Based Response

by Timothy Stoltzfus Jost

Overview

No developed nation relies exclusively on the private sector to finance health care for citizens. This book begins by exploring the deficiencies in private health insurance that account for this. It then recounts the history and examines the legal character of America's public health care entitlements - Medicare, Medicaid, and tax subsidies for employment-related health benefits. These programs are increasingly embattled, attacked by those advocating privatization (replacing public with private insurance); individualization (replacing group and community-based insurance with approaches based on individual choice within markets); and devolution (devolving authority over entitlements to state governments and to private entities). Jost critically analyzes this movement toward disentitlement. He also examines the primary models for structuring health care entitlements in other countries - general taxation-funded national health insurance and social insurance - and considers what we can learn from these models. The book concludes by describing what an American entitlement-based health care system could look like, and in particular how the legal characteristics of our entitlement programs could be structured to support the long-term sustainability of these vital programs.

Product Details

ISBN-13:	9780190288051
Publisher:	Oxford University Press
Publication date:	04/10/2003
Sold by:	Barnes & Noble
Format:	eBook
File size:	2 MB

About the Author

Washington and Lee University, School of Law, Lexington, VA

Table of Contents

1.	Introduction	1
2.	Why Entitlements Matter	8
3.	The Nature of American Health-Care Entitlements	23
4.	The Historical Foundations of American Health-Care Entitlements	63
5.	Experiments with Privatization: Medicare and Medicaid Managed Care	110
6.	Medicare "Reform": Disentitlement through Privatization	138
7.	Health Insurance for the Poor: Disentitlement through Devolution	162
8.	Tax Credits for Health Insurance: Disentitlement of America's Workers?	184
9.	The British National Health Service: The General Revenue-Financed Model of Health-Care Entitlements	204
10.	The German Health-Care System: The Social Insurance Model of Health-Care Entitlements	235
11.	Toward an Entitlement-Based Health-Care System	265
	Index	283

Editorial Reviews

"...a timely and important book. ...Efforts to privatize, devolve, and individualize health insurance may resonate with many lawmakers and members of the American public, particularly in these times of an uncertain economy and expanding government deficits; but Professor Jost's book reminds us that we need to carefully examine the premises and promises of these reform initiatives." —The Journal of Legal Medicine"

From the Publisher