Chapter

Legal, Political, and Ethical Concerns

Peter J. Neumann

in Using Cost-Effectiveness Analysis to Improve Health Care

Published in print December 2004 | ISBN: 9780195171860
Published online September 2009 | e-ISBN: 9780199865345 | DOI: http://dx.doi.org/10.1093/acprof:oso/9780195171860.003.0005
Legal, Political, and Ethical Concerns

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This chapter describes legal, political, and ethical concerns surrounding the use of cost-effectiveness analysis. It argues that each of these factors explains some of the resistance to CEA but also has shortcomings. Nothing in federal statute explicitly bars Medicare from using CEA. Similarly, nothing prevents private health insurers from writing contracts that specify covered services as those that are deemed “medically necessary and cost-effective.” Plans may fear lawsuits if they use cost-effectiveness openly. But there are also plausible reasons to believe that health plans could withstand these challenges, as they have withstood challenges to other cost containment initiatives. There are ethical challenges but other countries have managed to overcome them.

Keywords: cost-effectiveness analysis; medical ethics; healthcare; Medicare

Chapter.  5647 words. 

Subjects: Public Health and Epidemiology

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