No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence

Hardcover | May 5, 2004

bySteven D. Pearson, James Sabin, Ezekiel J. Emanuel

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Can the ethical mission of health care survive among organizations competing for survival in the marketplace? On this question hinges not only the future of health care in the US, but that of the health care systems of all advanced countries. This book presents both an analytic framework anda menu of pragmatic answers. The team of authors, physician-ethicists from Harvard Medical School and the National Institutes of Health, worked with a consortium of health care organizations to explore some of the most challenging dilemmas in health care today: How can health plans determinemedical necessity in a way that ensures quality care, controls costs, and builds trust with patients and physicians? What are the strategies for caring for vulnerable populations that meet their special neds without dramatically increasing costs? To answer these and other similar questions theauthors blend ethical analysis with real-world example. The outcome is a rich analysis of the ethical challenges facing health care organizations, combined with tangible examples of exemplary methods to address these challenges. This book will help health care leaders, regulators, and policymakers incorporate exemplary practices, and the underlying themes they embody, into the very heart and soul of health care organizations.

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Can the ethical mission of health care survive among organizations competing for survival in the marketplace? On this question hinges not only the future of health care in the US, but that of the health care systems of all advanced countries. This book presents both an analytic framework anda menu of pragmatic answers. The team of a...

Steven D. Pearson and James Sabin are both at Harvard Medical School and Harvard Pilgrim Health Care. Ezekiel J. Emanuel is at the Warren G. Magnuson Clinical Center, National Institutes of Health.

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Format:HardcoverDimensions:192 pages, 6.1 × 9.21 × 0.91 inPublished:May 5, 2004Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195158962

ISBN - 13:9780195158960

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Table of Contents

1. Virtue Among the Ruins?2. Evidence-based Ethics and The BEST Project3. Organizational Ethics4. Consumer Empowerment5. Medical Necessity, Coverage Decisions, and Medical Policy6. Care of Vulnerable Populations7. Community Benefit8. Confidentiality9. Conclusion: The Perenial Ethical Challenges of Health Care in Competitive Systems

Editorial Reviews

"This is an informative, interesting and...inspirational examination of the ethical obligations, commitments and strategies of a number of health care organizations in the U.S...No Margin, No Mission serves as a powerful counterargument to all those who claim ethical reasoning and analysishave no "real-world" relevance for shaping a health care organization's business policy and practice."--Journal of Health Care for the Poor and Undeserved