Edited by Tom Sorrell, London, Routledge, 1998, 234 pages, £15.99 (pb)

The interface of health care and insurance requires not just the medical, legal and financial perspectives, but a clear ethical analysis. A varied team of contributors ranging from experts in philosophy, law, medicine and ethics to actuarial science, underwriting and insurance have contributed a series of essays. The book is divided into two parts. The first deals with ethical issues raised in underwriting. These deal with genetics, HIV and disability, as well as with the ethics of underwriting itself. Part two covers the thorny issue of whether insurance should be provided by the public or private sectors or some combination. The important issues of social and private health insurance, access to health care, insurance, pensions and long term care provision are explored.

As a “starter for ten” in the area of health care and insurance the variety of contributor and perspective certainly opens up the issues in a clear and helpful way. The essays (apart from the first two) stand alone and allow the reader to select and to follow his/her interest. The downside is that there is too little of a consistent thread through the argument, some inevitable repetition of argument, which is not always helpful or flagged up, and too little engagement with the nitty-gritty of the ethical positions and principles at the heart of the debate.

The book provides an excellent resource, but it is better on the range of issues than the depth of analysis and critique.