Medicine the Marketplace - by Kenman L Wong (Paperback)

Book Synopsis

The emerging dominance of managed care provided by profit-seeking corporations has intensified the public's concern that traditional business goals of maximizing profits will destroy medicine's traditional commitment to patient well-being. Society is left to wonder how physicians can properly honor their duties to patients when the managed care organizations that employ them have financial obligations to shareholders.

Kenman L. Wong's timely book addresses issues raised by the new intersections of business and medicine with an ethical assessment of emerging health care arrangements. By focusing on organizational ethics, he offers an integrative framework that seeks to balance patient, societal, and corporate interests. To avoid overly simplistic solutions, Wong compares managed care, traditional fee-for-service arrangements, and other proposed health care reform options such as rationing programs and medical savings accounts based upon principles of fairness.

Though Wong argues that managed care is the best available option, he finds fault with many current practices of managed care organizations. He evaluates the place of the profit motive in the guiding ethos of managed care organizations and addresses the pressing issue of whether or not managed care should remain the exclusive domain of nonprofit organizations. He concludes with an integration of business ethics and medical values that formulates organizational norms and specific practice reforms for managed care organizations.

Medicine and the Marketplace should be read by health care practitioners, plan administrators, instructors of medical ethics, health administration, and public policy, and members of the general public interested in how managed care can be made into an ethics-driven system.

Review Quotes

"Medicine and the Marketplace is thus a valuable contribution to the literature. Even if it does not provide fresh, startling insights, the book brings together a host of important ideas in the literature of business ethics, and makes them readily available to audiences who would not otherwise have them so easily, coherently, and powerfully available." --Medical Humanities Review

"[A]n interesting attempt to group together supporters of various positions according to their location on two continua -- the degree to which medical care should be managed by third parties external to the patient-physician relationship, and the degree to which accountability for cost and quality should rest with markets or individual professionals. It succeeds in... throwing light on the stance taken by different groups on managed care...." --Social Science and Medicine

"He (Wong) offers compelling reasons for health-care systems to adopt a capitalist business model in order to manage responsibly their delivery of medical care." --Theological Studies

"The tension between maximizing profits and caring for patients has been heightened by the growing prevalence of managed care systems. The author looks at these tensions with respect to organizational ethics and compares for-profit and not-for-profit managed care systems with fee-for-service, rationing, and medical savings account programs. An integration of medical, business, and organizational ethics, with an emphasis on Rawlsian justice, gives a value framework for ethical decision making in managed care." --The Hastings Center Report

"Wong offers a very comprehensive discussion of what managed care represents to the U.S. health care system in terms of quality and quantity of patient care. Well-researched viewpoints arguing in favor of and against managed care are offered... An excellent book, which actually frames some solutions for the chaotic health care delivery system the U.S. is currently facing." -Choice

"Wong's book is a critical and important first step in the debate on managed care and the discussion of business ethics in health care. It should be read by anyone interested in medical ethics." --Journal of Medical Ethics

"Wong's is a comprehensive analysis of the new ethical challenges raised by the concept of managed health care. Society is left to ask how physicians can properly honor their obligations to patients when the managed care organizations that employ them have an obligation to shareholders." --Abstracts of Public Administration, Development, and Environment

About the Author

Kenman L. Wong is Associate Professor of Business Ethics at Seattle Pacific University. He is co-author of Beyond Integrity: A Judeo-Christian Approach to Business Ethics (1996).