Review the sections on Cost Shifting Hits Private Plans and “Responding to Cost Shifting”
in Chapter 3 in Health Policy Analysis: An Interdisciplinary Approach. These sections
discuss a concept of a shift in thinking and practice that is sometimes referred loosely as
breaking the old social contract that existed in health care before managed care. The social
contract concept provides for responsibilities between the government and individuals to
be set forth in a negotiated agreement, hence the social contract. In this instance, the arena
for negotiation and compromise we are concerned with is health care.
(In a paper of 800?1,200 words, reflect on the social contract concept. If you were to think
about a new social contract, what would it be? Think in terms of two contracts: one
between the citizenry and the state, and one between the professionals and the health care
Provide a minimum of three references.
Social Contract Position Essay
A social contract is a theory or a philosophical model that is derived from the
enlightenment age. In definition a social contract depicts the distinct difference between the
power of the state over the civilians and the specific responsibilities being held by the two
parties. A social contract makes possible the state to have authority over its citizens.
Furthermore, the citizens are submissive to the state and are willing to forego any of their rights
or pleasures in aiding the authoritarian power of the state they inhabit (Dunn, 2015).
In a social context, a social contract has been explicitly defined by common law. The
concept of a social contract has been the framework for the foundation of most civilized nations
all over the world. It is not written or noted anywhere in law. Consequently, the social contract
concept guides the division of roles between the citizens and the states (Weimer et al, 2015).
Without the right mechanisms to deploy power over the people and reason for people to accept
power to be deployed over them. The world would have been a chaotic place.
SOCIAL CONTRACT POSITION ESSAY 2
It brings to light the administrative functions that occur in most organizations. And how
the different roles and responsibilities are defined in specified distinct scenarios. For instance,
the scenario regarding the health care sector. The healthcare sector has been running using a
given social contract that has clearly defined how health care services and products would be
duly offered to the customers (Almgren, 2012). However, this paper is going to come up with a
different social contract for the state and the citizenry and one for the health care sector.
Starting with the citizenry and the state. A clearly negotiated social contract for this age
of civilization would be very dynamic. With the change in how life is carried out on a daily to
daily basis around the world. The social contract is bound to change to adapt to current times.
Technology has brought to light the importance of communication. In the social contract for the
age of enlightenment, the power of the state is more. Meaning that by then, the state had the
power and the common citizen had no will to speak about the defiance or irresponsibility of the
Even though most laws have been changed in some countries regarding the degree of
power offered to the state. Some countries are still experiencing powerful states that oppress
the citizens beyond measure. In the current age and modern times we live in. The state should
be governed by the people and the people should govern the state. It is high time that the
citizens have enough power to scrutinize the state as much as the state has the power and
responsibility to make the citizens account for their wrong doings.
On the other hand, the health sector has clearly stated responsibilities that govern the
conduct of the health care practitioners over the patients. A social contract regarding the health
sector would therefore read as: the physician has control over the patient as long as the patient
is in the hands of the physician (Dunn, 2015). However, after provision of health care services,
SOCIAL CONTRACT POSITION ESSAY 3
the patient is held responsible for the actions that lead to either bodily harm or any other health
It would be prudent to have the managed care system be implemented in most health
care organizations all over the world. Managed care should be the core principle that guides the
conduct of the involved parties according to the social contract definition of the health sector.
Almgren, G. R. (2012). Health care politics, policy and services: a social justice analysis.
Springer Publishing Company.
Dunn, W. N. (2015). Public policy analysis. Routledge.
Weimer, D. L., & Vining, A. R. (2015). Policy analysis: Concepts and practice. Routledge.