This collection provides a philosophical and historical analysis of the development and current situation of managed care. It discusses the relationship between physician professionalism and patient rights to affordable, high quality care. Its special feature is its depth of analysis as the philosophical, social, and economic issues of managed care are developed. It will be of interest to educated readers in their role as patients and to all levels of medical and health care professionals.

in the culture of medicine, and they saw their mission as a generation of profit for stockholders, not necessarily medical care for clients. Cost-effective medicine was the goal in the context of a profit-making enterprise. Although preventive health care programs were promised, very few were realized and they were not nearly comprehensive. The definition of unnecessary testing slowly expanded to mean virtually any high-cost test requiring the service of a medical specialist, and low priced generalist physicians with limited diagnostic and therapeutic skills were made available to patients...

Human existence is marked by pain, limitation, disability, disease, suffering, and death. These facts of life and of death give ample grounds for characterizing much of the human condition as unfortunate. A core philosophical question is whether the circumstances are in addition unfair or unjust in the sense of justifying claims on the resources, time, and abilities of others. The temptation to use the languages of rights and of justice is und- standable. Faced with pain, disability, and death, it seems natural to complain that "someone should do something", "this is unfair", or "it just...