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CHAPTER 11 Delivering Health Care
CHAPTER OUTLINE
I. Background and Facts about Health Care
A. Definition
B. Problems in U.S. Health Care
C. Medicare
D. Medicaid
E. Managed Care
F. Affordable Care Act
II. Moral Theories and Health Care
A. Distributive Justice
B. Libertarianism
C. Egalitarianism
III. Moral Arguments and Health Care
A. Rawls’s Theory of Justice
B. Daniels’s Normal Species Functioning
C. Equal Right to Health Care
MULTIPLE CHOICE
1. Medical treatment, disease prevention, emergency care, and public health measures are
collectively referred to by the term
a. health care. c. Medicare.
b. fiduciary care. d. managed care.
2. The fundamental moral issue involved in the health care debate is justice, which is about
persons getting what is fair or what is their due. One of the ways we can ensure justice in
health care is to preserve the principle that requires that equals be treated equally unless there
is a morally relevant reason for treating them differently. This principle is called
a. egalitarianism. c. the means-ends principle.
b. the greatest happiness principle. d. impartiality.
3. The health insurance program supported jointly by the federal and individual state
governments that covers low-income families, pregnant women, families and children, and
people with disabilities is named
a. Social Security. c. Medicaid.
b. Medicare. d. Home Health Care.
4. Much of the health care in the United States is delivered through ________, a type of health
insurance in which providers contract with an HMO, PPO, or POS to offer health care to a
group of patients at discounted costs.
a. managed care c. telemedicine
b. private insurance companies d. subsidized insurance
5. The component of the Affordable Care Act called the individual mandate required that
individuals have
a. two-tiered health insurance.
b. basic health insurance, with some exceptions.
c. basic health insurance, with no exceptions.
d. health savings accounts (HSA).
6. The idea behind ________ is that in any society, morality demands that people receive what
they are due (what is fair).
a. natural law theory c. distributive justice
b. the ethics of care d. procedural justice
7. Theories of justice that hold that people are entitled only to what they can freely acquire
through their own legitimate efforts in a free market are called ________ theories.
a. socialist c. liberal
b. egalitarian d. libertarian
8. The primary difference between libertarian and egalitarian theories of justice is that
a. libertarian theories hold that there are only negative rights, while egalitarian theories hold that positive rights exist.
b. libertarian theories hold that there are no negative rights, while egalitarian theories hold that there are only negative rights.
c. libertarian theories hold that health care is a universal, positive right, while egalitarian theories hold that health care is no right at
all.
d. libertarian theories hold that it is impermissible to deny anyone health care, while egalitarian theories hold that it is permissible to
deny people health care.
9. The philosopher who stresses the value of health care in terms of preserving and restoring
“normal species functioning” is
a. John Rawls. c. Norman Daniels.
b. John Stuart Mill. d. Mary Ann Warren.
10. In his book A Theory of Justice the philosopher John Rawls argues that people are entitled
not to equal shares of the basic goods of society, but to an equal chance to acquire them. This
aspect of his worldview is called
a. equality of opportunity. c. equal benefits to all.
b. equal rights under the law. d. maximum equality to all.
11. In debates about health coverage, some have tried to distinguish between healthy people who
have lived their lives the “right way” and unhealthy people who have not taken proper care of
themselves, referred to as the “undeserving sick,” who do not deserve health care. Which of
the following theories of justice is most likely to underlie this perspective?
a. the criminal theory of justice c. the moderate theory of justice
b. the egalitarian theory of justice d. the libertarian theory of justice
TRUE/FALSE
1. The debate over delivering health care is primarily about the morality of individual actions
and decisions.
2. Despite having the most expensive health care system in the world, the United States ranks
near the bottom when compared to other industrialized countries on measures of health
system quality, efficiency, access to care, equity, and healthy lives, according to a recent
report.
3. Because managed care plans focus on costs and efficiency, some critics charge that this
emphasis on business values could ultimately degrade the quality of care.
4. While the Affordable Care Act aimed at providing solutions to the problems of lack of health
insurance coverage among millions of Americans and the seemingly unstoppable rise in health
care costs, Obamacare was intended to fix minor problems in health care.
5. Positive rights are those that only obligate others not to interfere with a person’s obtaining something.
6. Libertarians believe that, while people have a right not to be interfered with in their pursuit of
health care, no member of that society has a right to demand any share of health care from that
society, no matter how rich that society may be.
7. Louisa is an egalitarian about health care, which means she thinks citizens have only negative rights, not positive rights, to health care.
8. The concept of an equal right to health care necessarily includes universal equal access to all care resources.
9. The Affordable Care Act includes a requirement that health insurance plans cover certain preventive care, such as immunizations,
preventive care for children, and specified health screening tests for adults.
10. In the American health care system, those who don’t have the money to pay for health care,
even those with serious illnesses or injuries, often get no medical care at all because of
escalating costs.
SHORT ANSWER
1. The fundamental moral issue involved in the health care debate is ________, which is about persons getting what is fair or what is
their due.
2. ________ is a federally funded insurance program that covers people sixty-five and older,
some adults under sixty-five with disabilities, and people with end-stage kidney disease.
3. ________ concerns the fair distribution of a society’s benefits and burdens, such as taxes, jobs, income, government services, social
obligations, property, and rights.
4. As an alternative to thinking of equal rights to health care as requiring universal equal access
to all available health care resources, some people have suggested that every person has only
a weaker right to a ________ of health care, in which basic, necessary care is provided to
everyone.
