The ethics of managed care.

The shift to managed care has placed administrators and physicians in the position of balancing the good of the organization with the good of the individual. This "dual moral agency," according to authors John Golenski, Ed.D, and Mark Cloutier, M.P.H., M.P.P., of the Bioethics Consultation Group, is a key challenge for administrators and physicians under managed care.

A history of Oregon's Basic Health Services Act: an insider's account.

The state of Oregon has led the nation in creating legislation to guarantee universal access by establishing medical and funding priorities in a basic health care package. A preliminary prioritization project--known as the Oregon Medicaid Priority-Setting Project or the Golenski project--served as a "dry run" for Oregon's Basic Health Services Act passed in 1989. A list of 15 public policy principles developed from data gathered from citizen surveys was used as guide for participants in setting priorities. Oregon's pioneering attempt at creating a health care package using prioritization must be seen in the context of the state's particular democratic traditions.