Basic Benefits and Clinical Guidelines

This book explains how clinical guidelines might be used to define health care needs and basic benefits. It discusses certain technical issues of the model proposal, including the importance of considering both health outcome evidence and patient and public preferences.

David C. Hadorn, M.D., M.A. is a nationally recognized researcher and scholar in the areas of health policy analysis, health care resource allocation, and clinical practice guidelines. He currently holds research and policy positions at RAND in Santa Monica, CA and at the University of Colorado in Denver. Dr. Hadorn has published widely on resource allocation policy and on the development and use of clinical practice guidelines. In 1988, he earned a Master's degree in philosophy from the University of Colorado; in 1991, he completed a two-year fellowship at RAND in health services research.

Foreword -- Preface -- The Model Proposal: Designing Basic Benefit Plans Using Clinical Guidelines -- Defining Our Terms -- Necessary-Care Guidelines -- The Model Proposal -- Analysis of the Model Proposal -- Ethical Considerations -- Response to Callahan -- Technical Considerations -- Response to Kaplan -- Legal and Political Considerations I -- Legal and Political Considerations II -- Response to Greely and Havighurst -- Counterpoint: The Oregon Medicaid Experiment -- The Oregon Priority-Setting Process -- Epilog