This book explains how clinical guidelines might be used to define health care needs and basic benefits. It discusses certain technical issues of the model proposal, including the importance of considering both health outcome evidence and patient and public preferences.
Part One: The Model Proposal: Designing Basic Benefit Plans 1. Using Clinical Guidelines 2. Defining Our Terms 3. Necessary-Care Guidelines 4. The Model Proposal Part Two: Analysis of the Model Proposal 5. Ethical Considerations 6. Response to Callahan 7. Technical Considerations 8. Response to Kaplan 9. Legal and Political Considerations I 10. Legal and Political Considerations II 11. Response to Greely and Havighurst Part Three: Counterpoint: The Oregon Medicaid Experiment 12. The Oregon Priority-Setting Process