Medicine and the Marketplace

The emerging dominance of managed care provided by profit-seeking corporations has intensified the public's concern that traditional business goals of maximizing profits will destroy medicine's traditional commitment to patient well-being. Society is left to wonder how physicians can properly honor their duties to patients when the managed care organizations that employ them have financial obligations to shareholders. Kenman L. Wong's timely book addresses issues raised by the new intersections of business and medicine with an ethical assessment of emerging health care arrangements. By focusing on organizational ethics, he offers an integrative framework that seeks to balance patient, societal, and corporate interests. To avoid overly simplistic solutions, Wong compares managed care, traditional fee-for-service arrangements, and other proposed health care reform options such as rationing programs and medical savings accounts based upon principles of fairness. Though Wong argues that managed care is the best available option, he finds fault with many current practices of managed care organizations. He evaluates the place of the profit motive in the guiding ethos of managed care organizations and addresses the pressing issue of whether or not managed care should remain the exclusive domain of nonprofit organizations. He concludes with an integration of business ethics and medical values that formulates organizational norms and specific practice reforms for managed care organizations. Medicine and the Marketplace should be read by health care practitioners, plan administrators, instructors of medical ethics, health administration, and public policy, and members of the general public interested in how managed care can be made into an ethics-driven system.