Medicare's Embedded Ethics

The Challenge of Cost Control in an Aging Society

Sharon Kaufman and Wendy Max
Health Affairs Blog
March 28th, 2011

The ethical judgments embedded in the connections among evidence-based medicine, Medicare policy, standards of care, need and expectation are not acknowledged and have not been included in discussions of the causes of rising medical care costs.

While the technical yardsticks of safety and efficacy have been the basis for coverage decisions, the linkages from government-funded and industry-driven evidence to coverage approval, to standards of care and then to need, all include implicit ethical judgments and choices in and of themselves.

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