The American Journal of Bioethics, Volume 11, Issue 7, Page 16-18, July 2011.

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

The organizational self-assessment tool presented in this issue (Wynia et al. 2004) is a valuable contribution not merely to the ethics literature, but also, one hopes, to health insurer practice....

It is good for people to understand their insurance coverage and the reasoning that has shaped it, to be able to contribute their two cents if they want to, and to know that their plan has at least attempted to make decisons that are consistent, fair and compassionate. It is also good for them to be told that attention to cost is ethically required. Nevertheless, while following the recommendations of Wynia et al (2004) might make benefits design and administration appear (...) more fair, it will not do as much as they suggest for them to be more fair. (shrink)