Choice 评论

This title's important topic raises questions about individual rights to health care and how to finance services provided to those who cannot afford to pay for them. In this volume of essays, it is proposed that a way must be found to relieve the health care providers of the financial burden of the nation's uninsured indigents. There is a conflict between the unwritten right of all citizens to equal medical care and the right to work and pursue wealth-both are contrary to the goal of reducing medical costs as discussed in Chapter 1. A statistical analysis (Chapter 2) of data from the Annual Surveys of Hospitals for 1978 to 1982 indicates that teaching and public hospitals provide a disproportionate share of uncompensated medical care-a sizeable proportion of which arise from the intensive care of newborns, accident victims, and people suffering from certain malignancies. Policies must be developed that define how to support the development of capital-intensive new technology and how to ration very expensive new procedures. Among other topics discussed are various methods of subsidizing hospital care for the poor; the evolution of the Hill-Burton Act from a distributive program of providing facilities for general community use to a program with emphasis on the rights or entitlements of individual indigent patients to care; and why the practice of subsidizing free care by hospital patients who pay full charges has arisen. This book provides an excellent overview of this very important economic problem that will affect all of us. For all libraries.-H.W. Wallace, University of Pennsylvania