Is Managed Care Good for What Ails You? Ruminations on Race, Age and Class

Today, a utilitarian view of ethics is the dominating political approach in health care decision-making, disregarding the concerns of individuals and particular groups. This is an unwise approach as the benefits and burdens of particular health plans, such as with managed care or FFS, vary significantly with the age, racial, ethnic, socioeconomic and health status of individuals. Instead, legislators and courts should give appropriate weight to factors such as race, age, and class when evaluating the reasonableness or desirability of practices and polices adopted by managed care companies. This article proposes we should not undertake a policy which forces all Medicare recipients to enroll in managed care plans; in fact, managed care does not seem to provide many elderly people with due treatment of respect and dignity as they make negotiations in today’s health care system. Next, the article proposes the tort system as a critical tool particularly for the protection of senior citizens and people of color against lower standards of medical care. Finally, the article contends that only when we advance a policy that protects and enhances human dignity can managed care realize its potential in improving the availability of health care to people of color, the elderly, and the poor