Governments throughout the industrialized world make decisions that
fundamentally affect the quality and accessibility of medical care.
In the United States, despite the absence of universal health
insurance, these decisions have great influence on the practice of
In Medical Governance, David Weimer explores an
alternative regulatory approach to medical care based on the
delegation of decisions about the allocation of scarce medical
resources to private nonprofit organizations. He investigates the
specific development of rules for the U.S. organ transplant system
and details the conversion of a voluntary network of transplant
centers to one private rulemaker: the Organ Procurement and
Transplantation Network (OPTN).
As the case unfolds, Weimer demonstrates that the OPTN is more
efficient, nimble, and better at making evidence-based decisions
than a public agency; and the OPTN also protects accountability and
the public interest more than private for-profit organizations.
Weimer addresses similar governance arrangements as they could
apply to other areas of medicine, including medical records and the
control of Medicare expenditures, making this timely and useful
case study a valuable resource for debates over restructuring the
U.S. health care system.
Subjects: Health Sciences
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