Reasonable Rationing

Reasonable Rationing

Author: Ham, Chris

Publisher: McGraw-Hill Education (UK)

Published: 2003-05-01

Total Pages: 194

ISBN-13: 0335211852

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Health care rationing is a reality in much of the world, and priority setting is an issue of increasing importance. Choices about the use of health care budgets are inescapable and difficult. This study look at priority setting in the health services of several countries.


EBOOK: Reasonable Rationing

EBOOK: Reasonable Rationing

Author: Chris Ham

Publisher: McGraw-Hill Education (UK)

Published: 2003-05-16

Total Pages: 194

ISBN-13: 0335225675

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"Reasonable Rationing is must reading for those interested in how to connect theory about fair rationing processes to country-level practices. The five case studies reveal a deep tension between political pressures to accomodate interest group demands and ethically motivated efforts to improve both information and institutional procedures for setting fair limits to care. The authors frame the issues insightfully." - Professor Norman Daniels, Harvard School of Public Health . How are different countries setting priorities for health care? . What role does information and evidence on cost and effectiveness play? . How are institutions contributing to priority setting? . What are the lessons for policy makers? Priority setting in health care is an issue of increasing importance. Choices about the use of health care budgets are inescapable and difficult. A number of countries have sought to strengthen their approach to priority setting by drawing on research-based evidence on the cost and effectiveness of different treatments. This book brings together leading experts in the field to summarize and analyse the experience of priority setting in five countries: Canada, The Netherlands, New Zealand, Norway and the United Kingdom. Drawing on literature from a range of disciplines, it makes a significant contribution to the debate on the role of information and institutions in priority setting. Reasonable Rationing has been written with a broad readership in mind. It will be of interest to policy makers, health care professionals and health service managers, as well as students of health and social policy at advanced undergraduate and postgraduate levels.


Rationing Is Not a Four-Letter Word

Rationing Is Not a Four-Letter Word

Author: Philip M. Rosoff

Publisher: MIT Press

Published: 2014-07-18

Total Pages: 337

ISBN-13: 0262320770

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A provocative argument that the best way to deliver high-quality healthcare to Americans is to institute a comprehensive and fair system of rationing. Most people would agree that the healthcare system in the United States is a mess. Healthcare accounts for a larger percentage of gross domestic product in the United States than in any other industrialized nation, but health outcomes do not reflect this enormous investment. In this book, Philip Rosoff offers a provocative proposal for providing quality healthcare to all Americans and controlling the out-of-control costs that threaten the economy. He argues that rationing—often associated in the public's mind with such negatives as unplugging ventilators, death panels, and socialized medicine—is not a dirty word. A comprehensive, centralized, and fair system of rationing is the best way to distribute the benefits of modern medicine equitably while achieving significant cost savings. Rosoff points out that certain forms of rationing already exist when resources are scarce and demand high: the organ transplant system, for example, and the distribution of drugs during a shortage. He argues that if we incorporate certain key features from these systems, healthcare rationing would be fair—and acceptable politically. Rosoff considers such topics as fairness, decisions about which benefits should be subject to rationing, and whether to compensate those who are denied scarce resources. Finally, he offers a detailed discussion of what an effective and equitable healthcare rationing system would look like.


Fair Resource Allocation and Rationing at the Bedside

Fair Resource Allocation and Rationing at the Bedside

Author: Marion Danis

Publisher: Oxford University Press

Published: 2014-10-02

Total Pages: 481

ISBN-13: 0190225475

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Health systems need to set priorities fairly. In one way or another, part of this important task will fall to physicians. How do they make judgments about resource stewardship, and how should they do so? How can they make such decisions in a manner that is compatible with their clinical duties to patients? In this book, philosophers, bioethicists, physicians, lawyers and health policy experts make the case that priority setting and rationing contribute significantly to the possibility of affordable and fair healthcare and that clinicians play an indispensable role in that process. The book depicts the results of a survey of European physicians about their experiences with rationing and other cost containment strategies, and their perception of scarcity and fairness in their health care systems. Responding to and complementing these findings, commentators discuss why resource allocation and bedside rationing is necessary and justifiable. The book explores how bedside rationing relates to clinical judgments about medical necessity and medical indications, marginal benefits, weak evidence based medicine, off-label use. The book highlights how comparative studies of health care systems can advance more effective and fair bedside rationing through learning from one another. From a practical standpoint, the book offers a number of strategies for health care systems and clinicians to work in tandem to allocate and ration resources as fairly as possible: how to foster more attention to fairness when rationing at the bedside, how to avoid exacerbating health disparities when allocating resources, how to teach about bedside rationing to students, how to discuss rationing more explicitly in the public arena and in the doctor's office.


Rationing Is Not a Four-Letter Word

Rationing Is Not a Four-Letter Word

Author: Philip M. Rosoff

Publisher: MIT Press

Published: 2014-07-03

Total Pages: 337

ISBN-13: 0262027496

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In this book, Philip Rosoff offers a provocative proposal for providing quality healthcare to all Americans and controlling the out-of-control costs that threaten the economy. He argues that rationing--often associated in the public's mind with such negatives as unplugging ventilators, death panels, and socialized medicine--is not a dirty word. A comprehensive, centralized, and fair system of rationing is the best way to distribute the benefits of modern medicine equitably while achieving significant cost savings.


Rationing Health Care

Rationing Health Care

Author: André den Exter

Publisher: Maklu

Published: 2012

Total Pages: 252

ISBN-13: 9046605256

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'Medical need' is a factor in health care access decision-making, but merit-considerations are becoming important too. In the shortening of waiting time, priority arrangements are considered and/or introduced, based on non-medical criteria. Simultaneously, in terms of financing, health status has become important due to payment arrangements, limited insurance package options, etc. At the same time, health status disparities, due to socioeconomic inequalities, seem to be increasing. Under these circumstances, confronted with increased health spending, it is expected that rationing will become more eminent. Due to this, the emerging relevant questions are: Who will be responsible for rationing (the market, governments, bureaucrats, physicians, or others)? * How does it function (explicit or implicit)? * What are relevant and acceptable selection criteria (QUALYs, DALYs, health status, sex, age, etc.)? * To what extent is current rationing just? * What can be done to make it more just? *


Drawing the Line

Drawing the Line

Author: Philip M. Rosoff

Publisher: Oxford University Press

Published: 2017

Total Pages: 329

ISBN-13: 019020656X

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American healthcare is neither efficient nor available to all, and is also the most expensive in the world. This book argues that rationing of healthcare could work and proposes an approach to ration fairly, effectively and generously.


Health Care for Some

Health Care for Some

Author: Beatrix Hoffman

Publisher: University of Chicago Press

Published: 2012-09-15

Total Pages: 357

ISBN-13: 0226348032

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The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.


Pricing Life

Pricing Life

Author: Peter A. Ubel

Publisher: MIT Press

Published: 2000

Total Pages: 236

ISBN-13: 9780262710091

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A rational look at health care rationing, from ethical, economic, psychological, and clinical perspectives. Although managed health care is a hot topic, too few discussions focus on health care rationing--who lives and who dies, death versus dollars. In this book physician and bioethicist Peter A. Ubel argues that physicians, health insurance companies, managed care organizations, and governments need to consider the cost-effectiveness of many new health care technologies. In particular, they need to think about how best to ration health care. Ubel believes that standard medical training should provide physicians with the expertise to decide when to withhold health care from patients. He discusses the moral questions raised by this position, and by health care rationing in general. He incorporates ethical arguments about the appropriate role of cost-effectiveness analysis in health care rationing, empirical research about how the general public wants to ration care, and clinical insights based on his practice of general internal medicine. Straddling the fields of ethics, economics, research psychology, and clinical medicine, he moves the debate forward from whether to ration to how to ration. The discussion is enlivened by actual case studies.