Taming the Beloved Beast (ebook)

Argumento de Taming the Beloved Beast (ebook)

Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone?

In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst.

Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.

"This book reflects the author's expertise not only as a researcher but also as a philosopher. He presents his arguments, discusses alternatives, and anticipates counterarguments, all with ample citations. . . . [T]his book will engage readers seeking to gain insight on health care reform and cost control from the perspective of a pragmatic philosopher."--Leslie R. Pyenson, Psychiatric Services

"Dan Callahan is one of the most important thinkers in health care today. Love him or hate him, you need to reckon with his ideas. Taming the Beloved Beast is a direct challenge to the central health care issue of our time--the capability and cost of medical care."--David Cutler, Harvard University

"An extraordinarily clear and important contribution. Callahan argues that many new medical technologies yield only very marginal benefits relative to their high costs for the majority of those who receive them. This book should be of interest to everyone who is involved in any way with health care policy and health reform issues."--Leonard M. Fleck, Michigan State University

"This is the only major book of which I am aware that places the escalating costs of medical technology at the center of the health care reform maelstrom. Callahan explains why we are facing a serious and urgent crisis in health care spending and why a cultural revolution is needed to bring about meaningful and sustainable change."--Alan B. Cohen, Boston University Health Policy Institute

"The rising cost of health care has preoccupied policy makers and the public for decades. Callahan contends that the principal cause of rising costs lies in Americans' infatuation with new medical technologies. . . . Callahan argues that the U.S. must rethink the goals of medical technologies and accept new limits on the availability and appropriate use of expensive medical treatments."--Choice

"While bringing insightful ethical, social, political and economic perspectives to this timely, well-documented discourse of the ballooning costs of American health care and Medicare, Callahan concentrates on the growing costs of medical technology, which, along with uncontrolled governmental healthcare spending, threaten to drag this country into financial crisis. . . . This excellent overview of reaching the goal of universal health care is a good resource for anyone concerned with the future of health care and its economics."--Library Journal

"No one who comes to Taming the Beloved Beast with an open mind can deny the intellectual and ethical power of the questions he poses. He probes issues central to resolving the enormous problems and inequities--not to mention the looming financial threats--that bedevil American medical care."--Beryl Lieff Benderly, Science

One of Library Journal's Best Sci-Tech Books, Health Sciences category for 2009
Recommended Reading, 2011 James A. Hamilton Award, American College of Healthcare Executives0Preface ix
Introduction 1
CHAPter 1: Medicare on the Ropes 10
CHAPter 2: Taming the Beloved Beast: Medical Technology 37
CHAPter 3: Getting Serious about Costs and Technology 67
CHAPter 4: Competition: The Fix That Will Fail 92
CHAPter 5: The Cohabitation of Medicine and Commerce 120
CHAPter 6: "Medical Necessity": An All-But-Useless Concept 143
CHAPter 7: Redefining "Medical Necessity": From Individual Good to Common Good 171
CHAPter 8: Getting Out from Under: The Politics of Pain 201
Coda 229
Notes 235
Index 257