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Published online by Cambridge University Press: 23 January 2015
Health care has been a hot topic within the United States for over a decade. Despite the many changes that have taken place, health care—and more specifically, versions of what have been termed “managed care”—continues to be a subject of intense debate and ongoing change. Whether the discussion is about access to care, quality of services, costs of care, or strains in the health care provider-patient relationship, a wide variety of stakeholders (e.g., patients, health care providers, health care organizations) have expressed frustration with the health care system. One of the central rallying cries behind the debate about health care is concern about the influence of “business” on health care. This special issue emerges out of the recognition that health care remains in flux, that health care continues to be a controversial subject among a wide array of stakeholders, and that the influence of business on health care is a key underlying source of tension.
Part of this debate has to do with what constitutes a just health care system. On the one hand, people in our society want to have access to high-quality care. More specifically, they want to be able to utilize the latest technology, care that is available when they need it (especially in crisis), a highly skilled care provider they can trust and develop a relationship with, and to not have to wait to gain access. On the other hand, people want a health care system they can afford. They want a health care system that is efficient, that offers reasonably priced services, and that doesn’t unduly strain the financial resources of families or the state.
I would like to thank a number of people who were instrumental in making this special issue happen. First, I’d like to thank Pat Werhane who first conceived of this special issue and convinced me to sign on. She did a great deal of work in helping to spread the word, solicit good manuscripts, review several of them, and give lots of advice to this first time editor. Second, I want to thank George Brenkert for his editorial acumen. He carefully read each manuscript and provided detailed suggestions on how to improve the quality of each of the papers during the review process. Third, I’d like to thank Al Gini and the capable staff at BEQ for their help in getting this edition into print. And finally, I’d like to thank all the reviewers and authors who contributed to the issue: Jessica Berg, Heather Elms, Linda Emmanuel, Ed Freeman, Paul Glezen, Ann Mills, Ed Spencer, and John Paris. Their efforts and ideas are the backbone of scholarly research, and the quality of these papers is a reflection of their hard work. To them, and to all who helped make this issue happen, I offer my sincere thanks.
1 Robert Veatch, Marcia Angell, and Norman Levinsky are a few of the more prominent bioethicists who maintain that any considerations of cost at the bedside are inappropriate and violate a care-giver’s duties to the patient. See, for example, Angell (1993), “The Doctor as Double Agent,” Kennedy Institute of Ethics Journal 3(3): 279–286.
2 Andrew C. Wicks. 1995. “The Business Ethics Movement: Where Are We Headed and What Can We Learn from Our Colleagues in Bioethics?” Business Ethics Quarterly 5(3): 603–20.