HEALTH CARE RATIONING Abstract The purpose of

The purpose of this report was to examine health care rationing. To this end, the report addressed several areas including the advantages and disadvantages of rationing, the Oregon plan for rationing of health care, and the allocation of organs and other scarce medical resources among patients. Regarding the allocation of organs and scare resources, three topics were covered. These concerned allocations associated with considerations of age, terminal illness, and unhealthy lifestyle.

Health care rationing was defined as the disbursement or allocation of health care services and supplies based on costs. It was noted that the primary advantages of the system are that it reduces health care costs while maintaining quality and that it provides the state with the capability for universal access. The primary disadvantage was said to involve the moral and ethical issues such as decisions about what procedures to ration and who society might accept as best fitted to make the decision.

It was concluded that there are sound reasons for developing a policy for the rationing of health care but that the developed policy should probably limit itself to practices and procedures which, if withheld, will not result in the death of a person that could be saved. Such a policy might not hold done costs as effectively as if life-saving procedures were withheld but it would nonetheless assist in holding down some costs, especially if it were combined

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son (1991), the Oregon plan was developed to handle several problems besetting the health care field in general and Oregon in particular. These problems included the continued escalation of health care costs, inequities in physician reimbursement, the large numbers of uninsured and underinsured Americans, and geographic variations in use of health care services. The plan does address and deal with many of these issues. Nonetheless, the Oregon Health Care Rationing plan is not without its problems. For example, it has been criticized for its failure to consider costs associated with no or alternative treatments, for arbitrary definition of key terms in the service category labels, and for the lack of reliability and validity testing of the methods used to estimate outcomes and preferences. For a plan that has, as one of its outcomes, the denial of life-saving treatments, these criticisms are not without serious import. Hadorn (1991) has noted that of the other criticisms that have been leveled against the plan (e.g. failure to include cost-effectiveness implications of the program for the poor), the most difficult to deal with is that the priority list, in some cases, favors minor treatments over life-saving treatments. H

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