Administering Health Care Services: an Ethical Analysis of Managed Care

Managed Care is an administrative apporach to distributing health care resources. It has been developed and integrated within the neo-liberal market of the United States from where it has been exported globally. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater consumer choice. However, under managed care, it can be seen that the pursuit of cost control, if not actual profit, becomes the primary objective of health care activity. Accordingly, the ethical purposes of health care provision are displaced by the economic purposes of the so-called 'free' market. In this way, the integrity of both health care practitioners and communities is corrupted. At the same time, it can be seen that the claims of managed care proponents to higher levels of efficiency and consumer choice are largely unfounded; indeed, consequent to market competition, costs have escalated while access has diminished. Nonetheless, when protected within a non-market or solidarity- based context, subject to the requirements of justice, a limited number of managed care techniques can assist in efforts to conserve health care resources.