Unmanaged Care: Towards Moral Fairness in Health Care Coverage
Abstract
Health insurers are generally guided by the principle of actuarial fairness, according to which they distinguish among various risks on the basis of cost-related factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately 42 million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned about what I call moral fairness. This is evidenced by the hundreds of laws that have been passed to constrain insurers' discretion with respect to particular coverage decisions. Legislative mandates are frequent, but seemingly haphazard, following no systematic methodology. The Article suggests an analytical framework that can be utilized to determine which interventions are appropriate and evaluates a variety of means by which moral fairness could be promoted in the arena of health care coverage.
Keywords
Health Care Coverage, Health Insurance, Uninsured, Moral fairness in health, distributional justice, health care reform, universal health care
Publication Date
2003
Document Type
Article
Place of Original Publication
Indiana Law Journal
Publication Information
78 Indiana Law Journal 659 (2003)
Repository Citation
Hoffman, Sharona, "Unmanaged Care: Towards Moral Fairness in Health Care Coverage" (2003). Faculty Publications. 694.
https://scholarlycommons.law.case.edu/faculty_publications/694
