It surprises people (especially international students) to learn that the U.S. Constitution doesÂ notÂ provide for a right to health care for American citizens.Â Â A key exception to that is prisoners, as Justice Marshall explains in theÂ GambleÂ case excerpt.Â They do have a right to minimum health care, because of the Eight Amendment.Â Â
Do you think, as a policy matter, thatÂ
allÂ Americans should have a right to minimum health care?Â This is the first discussion question for the week.
Your book talks about another type of financial concern we might have with physicians, namely, physician ownership of treatment facilities.Â If a physician owns a treatment facility, you can see why he might be more eager to recommend patients use itâ€”or to recommend less lucrative patients use his competitorâ€™s facilities.Â The flip side is that not allowing physicians to refer to their facilities might create extra administrative cost and inefficiency.Â The law polices physician ownership in several ways and bars it in many instances.Â One place it does not bar ownership is with respect to facilities known as ambulatory service centers, which are in essence a kind of lower cost treatment alternative to hospitals.Â The study in the book shows how it does indeed look like physicians, in making referrals to ASCs they own or do not own, seem to take into account their own financial returns.Â
Do you think that is a problem?Â If so, is a better solution an outright bar of the practice or merely requiring doctors to disclose to their patients their ownership interests in treatment facilities?Â This is the second discussion question for the week.
Do Kenneth Arrowâ€™s insights suggest health insurance is best provided by the government, private payers, or a combination of both?Â This is the third discussion question of the week.
If we could have a system where anyone of any age could opt-in to Medicare by paying a modest premium, would you prefer that system?Â Why or why not?Â This is the fourth discussion question of the week.
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