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Volume 328:1358-1359 May 6, 1993 Number 18
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Economics and Ethics in Health Care
The Hippocratic Predicament: Affordability, Access, and Accountability in American Medicine

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By Robert M. Kaplan. 275 pp. San Diego, Calif., Academic Press, 1993. $64.95. ISBN 0-12-397370-8.

As the health care-delivery system is reshaped in an age of limits, the issue of allocation sharpens. What is the most efficient and the most just distribution of scarce health care resources? One way to address this question is to rank the benefits and burdens of various interventions. But how can society compare acute care "apples" like appendectomies with preventive "oranges" like immunizations and long-term care "peaches" like insulin maintenance for diabetes? The answer, according to Robert Kaplan, lies in the development of a common unit of health benefit that can be used to assess the value of all interventions. . . . [Full Text of this Article]




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