Full Description
Despite the attention to the problem of protecting the health care interests of Americans, there is little consensus on what should be done politically or otherwise to address this problem. In Protecting American Health Care Consumers Eleanor DeArman Kinney, a nationally regarded expert on health policy and law, tackles the serious and ongoing debate among state and federal policymakers, health care providers, third-party payers, and consumers about how to provide procedural justice to patients in the present health care climate.
To promote and ensure consumer protection in an increasingly adversarial and complicated health-care culture, Kinney first analyzes the procedures by which consumer concerns are presently discerned and resolved and then explains why these systems are unsatisfactory. She also discusses problematic procedures for making coverage policy and quality standards and proposes reforms in a variety of processes that would enable all consumers, including the uninsured, to influence key policies and standards and also to raise concerns and obtain appropriate remedies.
As the first comprehensive treatment of administrative procedures in American health plans and other such institutions, Protecting American Health Care Consumers will be welcomed by state and federal policymakers, managed care executives, and lawyers charged with designing and implementing protections for consumers in public and private health plans.
Contents
Acknowledgments
1. Introduction
2. The Patient Protection Debate
3. Health Insurance Coverage in the United States
4. Relevant Law and Theory
5. The Universe of Consumer Concerns about Health Care
6. The Universe of Medical Standards and Other Policies Regarding Health Care
7. Processes for Making Policies Regarding Health Care
8. Regimes for Tapping and Resolving Consumer Concerns about Health Care
9. Principles of Sound Procedural Protections
10. A Vision of Reform
Notes
Index
