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Chronic illness: not-so-passive injustice?

Norman Daniels

    The Journal of Clinical Ethics
    |October 1, 1991
    PubMed
    Summary

    The current healthcare system, focused on acute care, fails the chronically ill due to limitations in employment-based private insurance. Reforming insurance is essential to better serve those with chronic conditions.

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    Area of Science:

    • Healthcare systems research
    • Health economics
    • Public health policy

    Background:

    • The current healthcare system predominantly prioritizes acute care services.
    • This focus leads to significant underservice of individuals with chronic illnesses.
    • Employment-based private insurance models present challenges for the chronically ill population.

    Purpose of the Study:

    • To investigate the reasons behind the healthcare system's bias towards acute care.
    • To analyze the inadequacy of employment-based insurance in serving the chronically ill.
    • To explore necessary reforms for improved chronic care delivery.

    Main Methods:

    • Qualitative analysis of healthcare system structures.
    • Examination of insurance policy implications for chronic conditions.
    • Literature review on healthcare delivery models for chronic illness.

    Main Results:

    • The primary barrier to serving the chronically ill is the structure of employment-based private insurance.
    • Individuals with chronic conditions often leave employment, making them ineligible for employer-sponsored insurance.
    • Existing insurance frameworks are not designed to meet the ongoing needs of the chronically ill.

    Conclusions:

    • The system's bias toward acute care neglects the chronically ill due to insurance limitations.
    • Shifting chronic care to home or family settings requires fundamental insurance system reform.
    • Reforming the insurance system is a prerequisite for effectively addressing the needs of the chronically ill.
    Keywords:
    Health Care and Public Health

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