HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mariner, W K Search for Related Content PubMed PubMed Citation Articles by Mariner, W K

Patients' rights after health care reform: who decides what is medically necessary?

W K Mariner

School of Public Health, Boston University, MA 02118-2394.

President Clinton's Health Security Act entitles individuals not to unlimited health care, but to a package of defined insurance benefits with specific exclusions and limitations. Like virtually all reform proposals, it would limit covered benefits to services that are medically necessary. If health reform is to control costs, not all medically necessary care can be covered. In the absence of a generally accepted definition of medical necessity, many services will not be guaranteed to all patients unless they are explicitly covered in the federal legislation or regulations. Without a federal definition of medical necessity or regulations listing covered services, health insurance plans will retain the primary authority to decide what is medically necessary for their patient subscribers.

This article has been cited by other articles:

				E. H. Morreim Quality of Life: Erosions and Opportunities Under Managed Care J. Law Med. Ethics, June 1, 2000; 28(2): 144 - 158. [PDF]

				W. K. Mariner Business vs. Medical Ethics: Conflicting Standards for Managed Care J. Law Med. Ethics, September 1, 1995; 23(3): 236 - 246. [PDF]

				G. J. Annas When Should Preventive Treatment Be Paid for by Health Insurance? N. Engl. J. Med., October 13, 1994; 331(15): 1027 - 1030. [Full Text]