Search PubMed⌕ Search

Biomedical subjects

R D Lamm

Publications and source records attributed to R D Lamm.

At least 19 recordsLinked to original sources
PubMed1996

Regulating the health professions: a tale of two jurisdictions.

Public policy is increasingly asking: What public policy objectives are achieved by a particular law regulating private acts or licensing a profession? These questions are particularly being asked of the health professions. There is a growing feeling that state legislatures are using licensing laws for purposes other than consumer protection and quality assurance, which are widely believed to be the only legitimate goals of occupational regulation. Are we protecting the profession or the public? These questions will not go away. Two jurisdictions, Ontario and Maine, illustrate this debate.

Health Occupations↗
PubMed1994

Saint Martin of Tours in a new world of medical ethics.

I end with another parable, but it is also a true story. Harvey Cushing, the famous surgeon after whom the Cushing Lectures are named, made an international reputation in his allegiance to quality. He badgered his profession to a higher standard of self-effacement and railed against the debasement of clinical skills and overemphasis on research and pursuit of personal gain. We honor him to this day because those were, and remain, important points. Yet, Harvey Cushing served as a surgeon during World War I and at Ypres. Although the Allied mortality was as much as 50,000 soldiers a day, not counting the wounded, Cushing refused to operate on any more than two patients each day, arguing that to do so would have lowered his standard of care for his patients--a standard that made sense in one time but that became strikingly insensitive, and I suggest even unethical, in another when confronted with a different reality. The ethical claims for professional autonomy based on such standards of professional ethics has had the effect of supporting widespread distributional inequities. These inequities are clearly a form of rationing that have been condoned implicitly by the professional ethics in the name of professional autonomy. Many of the condemnations we hear today of prospective payment systems and how they will "ration" medicine contain a similar sense of unreality. The high standards are laudatory, but they should not be used as an excuse to not meet other pressing needs. High standards should never be used to make a problem worse.(ABSTRACT TRUNCATED AT 250 WORDS)

Christianity↗
PubMed1994

Rationing and the Clinton health plan.

President Clinton, already facing formidable obstacles in reforming the health care system, denies that it will involve any rationing. This is politically understandable, but wrong. Infinite needs are rapidly overtaking finite resources. Most health providers recognize that the genius of modern medicine has outpaced our ability to pay. But the public still has unlimited expectations and a blind faith that everything can be provided to everyone by simply eliminating "waste, fraud, and abuse." Rationing is inherent in any health care system. As government undertakes to define what is "medically necessary or appropriate," it will unavoidably undertake a series of rationing decisions. Health care is being transformed from a private good to a public good. Government, when it reforms the health care system, must inevitably ask: How do we buy the most health for the public?

Delivery of Health Care↗
PubMed1993

The Democratic Party takes on healthcare reform.

The public is expecting delivery on the Democratic Party's election promises of healthcare reform. Now, with a Democrat in the White House and a Democratic majority in Congress, the time seems ripe for real reform. But unity continues to elude the party on this hot issue, says former Colorado Governor Dick Lamm.

Cost Control↗