Synopsis
In this seminal work, distinguished legal scholar Richard Epstein daringly refutes the assumption that health care is a “right” that should be available to all Americans. Such thinking, he argues, has fundamentally distorted our national debate on health care by focusing the controversy on the unrealistic goal of government-provided universal access, instead of what can be reasonably provided to the largest number of people given the nation's limited resources.With bracing clarity, Epstein examines the entire range of health-care issues, from euthanasia and organ donation to the contentious questions surrounding access. Basing his argument in our common law traditions that limit the collective responsibility for an individual's welfare, he provides a political/economic analysis which suggests that unregulated provision of health care will, in the long run, guarantee greater access to quality medical care for more people. Any system, too, must be weighed on principles of market efficiency. But such analysis, in his view, must take into account a society-wide as well as an individual perspective. On this basis, for example, he concludes that older citizens are currently getting too much care at the expense of younger Americans.The author's authoritative analysis leads to strong conclusions. HMOs and managed care, he argues, are the best way we know to distribute health care, despite some damage to the quality of the physician-patient relationship and the risk of inadequate care. In a similar vein, he maintains that voluntary private markets in human organs would be much more effective in making organs available for transplant operations than the current system of state control. In examining these complex issues, Epstein returns again and again to one simple theme: by what right does the state prevent individuals from doing what they want with their own bodies, their own lives, and their own fortunes?Like all of Richard Epstein's works, Mortal Peril is sure to create controversy. It will be essential reading as health-care reform once again moves to the center of American political debate.
Reviews
A legal scholar's densely written argument that the good old days of laissez-faire were better. Epstein (Univ. of Chicago) claims that the welfare of the general population has been brought into mortal peril by the assumption that a proper health care system requires government controls. He traces the evolution of ideas of rights from the common-law concept of negative rights (freedom from the actions of others) to the more modern system of positive rights--to life, liberty, the pursuit of happiness, and by extension to health, housing, education, and other desirable ends. The latter system, he complains, targets the state with duties of support, builds in extensive taxation, and forces the redistribution of wealth. In his view, the old common-law rules do a far better job of providing health care than the present complexity of government regulations with their many unintended and harmful consequences. Thus, he sharply criticizes Medicare and Medicaid, with their emphasis on expanding access and subsidizing services, and the Clinton administration's failed health care proposals for further broadening access. A defender of autonomy rights, property rights, and contractual freedom, Epstein next focuses on specific areas in which the state prevents individuals from doing what they want with their bodies and their lives. His defense of baby-selling and surrogate motherhood, his advocacy of a free and open market in organs for transplant, and his arguments for removing the ban on euthanasia and assisted suicide are sure to arouse protests from many quarters. His thesis that an unregulated health care system will ultimately provide better care and better access to greater numbers of people is, if not disingenuous, certainly disputable. -- Copyright ©1997, Kirkus Associates, LP. All rights reserved.
Noted legal scholar Epstein challenges the right to universal healthcare, deriving his fundamental argument from his own interpretation of common law, the basis of American justice. Epstein argues that the system of rights and duties enshrined in common-law principles cannot be extended as obligations to provide care and assistance. He fears that state control of redistributive taxation threatens to shift entitlements from old to young and rich to poor and guarantees state support for a system of healthcare that, in the long run, may not provide an adequate structure for reform and regulation. Examined here are the notions of positive rights to healthcare, limited access, comprehensive care, and liability, particularly regarding the controversial topics of organ transplants and euthanasia. Well reasoned, scholarly, and controversial, this book is highly recommended for academic collections.?Mary Hemmings, Univ. of Calgary Lib., Alberta
Copyright 1997 Reed Business Information, Inc.
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