Medical governance works well when it engages professional expertise and advances appropriate values. To be effective, it must also accommodate conflicting interests. An alternative to traditional regulation is delegation to self-governing organizations of stakeholders. Medical Governance explores such delegation in the development of rules for the U.S. organ transplant system. It relates the conversion of the voluntary network of transplant centers to the Organ Procurement and Transplantation Network (OPTN), a private rulemaker. Detailed case studies of the evolution of rules for the supply and allocation of transplant organs— rules with literally life and death consequences—provide an empirical basis for assessing the OPTN. The cases show its exceptional effectiveness in implementing evidence-based medicine. To determine whether similar governance arrangements would be desirable in other areas of medicine, Medical Governance identifies the essential elements of the OPTN and demonstrates their application to the problems of medical records and the control of Medicare expenditures. The lessons from Medical Governance make an important and timely contribution to debates over restructuring of the U.S. health care system.
- medical governance,
- organ transplantation,
- private rulemaking
Available at: http://works.bepress.com/david_weimer/2/