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税务筹划在制造业中的运用 外文原文
TOWARDS A NEW MORAL PARADIGM IN HEALTH
CARE DELIVERY: ACCOUNTING FOR INDIVIDUALS
Meir Katz
J.D. Georgetown University Law Center
Abstract :For years, commentators have debated how to most appropriately
allocate scarce medical resources over large populations. In this paper, I abstract the
major rationing schema into three general approaches: rationing by price, quantity,
and prioritization. Each has both normative appeal and considerable weakness. After
exploring them, I present what some commentators have termed the “moral paradigm”
as an alternative to broader philosophies designed to encapsulate the universe of
options available to allocators (often termed the market, professional, and political
paradigms). While not itself an abstraction of any specific viable rationing scheme, it
provides a strong basis for the development of a new scheme that offers considerable
moral and political appeal often absent from traditionally employed rationing schema.
As I explain, the moral paradigm, in its strong, absolute, and uncompromising
version, is economically untenable. This paper articulates a modified version of the
moral paradigm that is pluralist in nature rather than absolute. It appeals to the moral,
emotional, and irrational sensibilities of each individual person. The moral paradigm,
so articulated, can complement any health care delivery system that policy-makers
adopt. It functions by granting individuals the ability to appeal to an administrative
adjudicatory board designated for this purpose. The adjudicatory board would have
the expertise and power to act in response to the complaints of individual aggrieved
patients, including those complaints that stem from the moral, religious, ethical,
emotional, irrational, or
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