Singer S E
William M. Mercer, Inc., USA.
Benefits Q. 1998;14(1):24-9.
Defining the scope of coverage and limitations in various health plans has become an increasingly difficult and confusing issue. The historical shift to managed care has fundamentally altered the limitations on health care benefits. Because of the existence of "benefits exclusions," confusing issues have emerged in managed care situations. Fundamental fear of health care rationing has raised the awareness of the general public to the ethics of this issue. This article discusses the definitions and examples of certain types of health benefit exclusions and the ethical considerations related to such exclusions.
界定各类健康保险计划的覆盖范围和限制已成为一个日益困难且令人困惑的问题。向管理式医疗的历史性转变从根本上改变了对医疗福利的限制。由于存在“福利排除条款”，在管理式医疗情形中出现了令人困惑的问题。对医疗资源配给的根本担忧提高了公众对这一问题伦理层面的认识。本文讨论了某些类型的健康福利排除条款的定义和示例，以及与此类排除条款相关的伦理考量。
