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Medical Necessity: Health Care Access and the Politics of Decision Making
How the politics of "medical necessity" complicates American health care
The definition of medical necessity has morphed over the years, from a singular physician's determination to a complex and dynamic political contest involving patients, medical companies, insurance companies, and government agencies. In this book, Daniel Skinner constructs a comprehensive understanding of the politics of defining this concept, arguing that sustained political engagement with medical necessity is essential to developing a health care system that meets basic public health objectives.
From medical marijuana to mental health to reproductive politics, the concept of medical necessity underscores many of the most divisive and contentious debates in American health care. Skinner's close reading of medical necessity's production illuminates the divides between perceptions of medical need as well as how the gatekeeper concept of medical necessity tends to frame medical objectives. He questions the wisdom of continuing to use medical necessity when thinking critically about vexing health care challenges, exploring the possibility that contracts, rights, and technology may resolve the contentious politics of medical necessity.
Skinner ultimately contends that a major shift is needed, one in which health care administrators, doctors, and patients admit that medical necessity is, at its base, a contestable political concept.
The definition of medical necessity has morphed over the years, from a singular physician's determination to a complex and dynamic political contest involving patients, medical companies, insurance companies, and government agencies. In this book, Daniel Skinner constructs a comprehensive understanding of the politics of defining this concept, arguing that sustained political engagement with medical necessity is essential to developing a health care system that meets basic public health objectives.
From medical marijuana to mental health to reproductive politics, the concept of medical necessity underscores many of the most divisive and contentious debates in American health care. Skinner's close reading of medical necessity's production illuminates the divides between perceptions of medical need as well as how the gatekeeper concept of medical necessity tends to frame medical objectives. He questions the wisdom of continuing to use medical necessity when thinking critically about vexing health care challenges, exploring the possibility that contracts, rights, and technology may resolve the contentious politics of medical necessity.
Skinner ultimately contends that a major shift is needed, one in which health care administrators, doctors, and patients admit that medical necessity is, at its base, a contestable political concept.
228 pages, Kindle Edition
Published December 24, 2019
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May 6, 2021
Excellent and thought-provoking discussions about concepts that I had taken for granted. I also really liked how philosophy was woven throughout and it made me interested to read more. I thought the structure of the book worked super well, starting with the concept of the archive, industries that have blown up around the current framing of health care, and then going to specific examples of how these concepts work (sometimes not very well) in different areas of health care, and I very much appreciated the straightforward sentences at the end of each chapter: i have tried to show you THIS, here. Grateful this book has been written and would LOVE to hear this author on other health care topics...
Displaying 1 of 1 review