Justice and Profit in Health Care Law

The issue of justice in the field of health care is becoming more central with concerns over access, cost and provision. Obamacare in the United States and the Health and Social Care Act 2012 in the United Kingdom are key examples illustrating the increasing pressure put on governments to find just and equitable solutions to the problem of health care provision. Justice and Profit in Health Care Law explores the influence of justice principles on the elaboration of laws reforming health care systems. By examining the role played by key for-profit stakeholders (doctors, employers and insurers), it tracks the evolution of distributive norms for the allocation of health care resources in western welfare states. Essentially, this book sheds light on the place given to justice in the health care law-making process in order to understand the place we wish to give these principles in future health care reforms.

1. Introduction
I. Justice, Profit and the Law
A. Profit and Health Care
B. Discourses of Justice
C. Legislative Intent
D. History and Health Care Reforms
II. Essential Elements of the Book
A. Methodological Considerations
B. Outline of the Book
2. Understanding Health Care as a Question of Justice
I. Introduction
II. Justice and the Allocation of Health Care Resources
III. Moral Political Philosophy and Universality of Care
A. Claims in Support of Universality of Care
B. Alternative Claims in Support of Universality of Care
C. Claims Against Universality of Care
IV. Organising Principles for Health Care Systems
A. The Principle of Solidarity
B. The Principle of Subsidiarity
V. Theories of a Right to Health and a Right to Health Care
A. The Egalitarian Perspective on a Right to Health Care
B. The Utilitarian Perspective on a Right to Health Care
C. The Communitarian Perspective on a Right to Health Care
D. The Libertarian Perspective on a Right to Health Care
E. Health as an Absolute Right
VI. Conclusion
3. For-Profit Stakeholders in American Health Care Policy
I. Introduction
II. The Overlapping History of American For-Profit Actors
A. Medical Professionals
B. Employers
C. Insurers
III. Contemporary Dynamics in Health Care Policy
A. The Issues: Costs and Other Barriers to Access Health Care
B. The Failed Solutions: Management and Cost-Containment
IV. Conclusion
4. Locating Ideas of Justice in American Health Care Reforms
I. Introduction
II. The Kerr–Mills Act (1960)
A. The Means Test and the New Welfare Category
B. Ideas of Liberal Equality
III. Medicare and Medicaid (1965)
A. Propositions from Insurers, Employers and the Medical Profession
B. Ideas of Welfare Equality
IV. The Health Maintenance Organization and Resources Development Act (1973)
A. A Cost Management Solution Supported by Insurers and Employers
B. Ideas of Libertarian and Communitarian Justice
V. The Affordable Care Act (2010)
A. Negotiating Universality Health Care with the For-Profit Sector
B. Libertarian Ideas of Justice Versus Ideas of Liberal Equality
C. An Unprecedented Judicial Battle
VI. Conclusion
5. For-Profit Stakeholders in British Health Care Policy
I. Introduction
II. The Medical Profession: A Defensive and Dissident Force
A. Establishing the Terms of the Concordat (1950s–70s)
B. Redefining the Roles (1980s–90s)
C. Adapting to the Dynamics of Consumerism in Health Care (2000s–the Present)
III. Private Initiatives in Health Care
A. Private Finance Initiatives: PFI and LIFT
B. Private Medical Insurance
C. The Independent Sector Responding to Consumerism in Health Care
IV. Conclusion
6. Locating Ideas of Justice in British Health Care Reforms
I. Introduction
II. The National Health Service Act (1946)
A. The Beveridge Report
B. The Foundations of the First Universal Health Care System
C. Ideas of Liberal Equality
III. The National Health Service and Community Care Act (1990)
A. Working for Patients
B. Ideas of Utilitarian Justice
IV. The Health and Social Care Act (2012)
A. Two White Papers, One Reform
B. Ideas of Libertarian Justice and Neoliberalism
V. Conclusion
7. Conclusion

“This book makes an interesting and timely contribution not only to better understanding of important health care reforms in the two countries analyzed, but more broadly to the literature in the field of privatization of health care.” –  Gema Ocana Noriega, I•CON

“In her book, Sabrina Germain takes us on a fascinating journey through the lawmaking process of seven healthcare policy reforms that occurred between 1946 and 2012 in the United States and the United Kingdom ... This book certainly is a wonderful contribution to the literature on healthcare law.” –  Marie-Eve Couture Ménard, Social & Legal Studies