Title: Competing Interests in Pediatric Managed Care Settings
Abstract: How well do managed care organizations meet the health care needs of children? What guides administrators and physicians as they participate in helping to make medical decisions involving children? Perhaps, more importantly, what should guide them? Are managed care organizations better at meeting the medical needs of some children and not others? If so, who and why? I intend to explore how medical decisions can be made that are in the "best interests" of both the insured child and the MCO. This entails a discussion of communitarian justice—regarding allocation of resources and rationing decisions—as well as attention to the acute health care needs of children as unique individuals with unique problems. What is the ethically appropriate response from MCOs to these patients? Is a utilitarian framework too harsh? Is a deontological model too expensive? My goal is to stimulate the development of some fundamental guidelines to assist MCO administrators, physicians and others when addressing the medical needs of all children.