Keller Graduate School
Prof. Michelle Gomillion
February 24, 2013
Rationing Healthcare: America's Best Bet
Within the last decade private insurance premiums have doubled, rising four times faster than wages. Insolvency of the current government assisted healthcare programs, Medicare and Medicaid, are on track to occur within the next eight years (Singer, 2009, para. 3). Facts such as these lead most experts and scholars such as Peter Singer, bioethics professor at Princeton University, to believe rationing of healthcare is not only necessary but highly desired for all stakeholders involved. The fact of the matter is that healthcare is a scarce resource, and like all scarce resources, it requires close management and rationing to ensure its best use. At present, healthcare in a sense, is rationed through price. In the realm of public opinion however, rationing healthcare is often times connected to the highly politicized word, ‘socialism’ and is highly undesired. In its truest form however, rationing simply put, is a way of distributing limited resources to garner the best overall “bang for the buck.” In healthcare, rationing is a manner of which providing the best quality of care to the largest number of patients. Investopedia defines rationing as: The artificial restriction of raw materials, goods or services. Rationing commonly occurs when governments fear a shortage and want to make sure people have access to necessities, such as after a natural disaster or during a war. Governments can also impose rationing in the face of failed policies such as central planning, or may be forced to use rationing as a result of shortages ("Definition of ’Rationing’," 2013, p. 1). This paper’s purpose is to examine the rationale behind the rationing of healthcare. It will examine the affect it has on healthcare delivery, impact on healthcare providers and consumers, possible solutions, and the role healthcare administrators/managers play in the process. The paper will reference institutions such as the National Institute for Health and Clinical Excellence (NICE) and other national healthcare systems like Great Britain, Australia, and Canada. In addition, a definition of quality-adjusted life-year will be presented and debated as a possible option to ration care fair and proportionately.
Affect Rationing Has on Healthcare Delivery.
Challenger’s arguement. Sally C. Pipes, Chief Executive officer of Pacific Research Institute and adversary to the rationing of healthcare, wrote an article titled “Obama Will Ration Your Healthcare.” Within the article, many subjects are discussed, including the National Institute for Health and Clinical Excellence (NICE), a rationing system that controls government costs. It is Pipes’ belief that rationing healthcare will result in the elderly population being discriminated against due to cost benefit analysis. Her article goes on further to state, “the process of determining which drugs and which treatments would be approved for use would be quickly politicized” (Pipes, 2008, para. 9). There is strong argument that rationing healthcare would ultimately fail in the hands of public opinion. To make this point, Pipes references lessons learned in managed care during the 1990’s. The goal of cost containment was successful however rejected by US citizens resulting in Congress passing a patient’s Bill of Rights (Pipes, 2008, para. 8). Other advocates against healthcare rationing state similar responses to Sally Pipes. Claire Andre and Manuel Velasquez, members of the Markkula Center for Applied Ethics, go as far as quoting Euripedes, 500 B.C.: I hate the men who would prolong their lives by foods and drinks and charms of magic art perverting nature's course to keep off death. They ought, when they no longer serve the land to quit this life, and clear the way for youth. It is their...