Category Archives: Rationing and Cost Effectiveness
August 21, 2009
August 21, 2009 > In deciding to cover a $200,000 open heart surgery procedure for heart failure, Medicare in effect denied giving that money to several more cost-effective strategies for preventing heart failure, including better access to blood pressure and lipid screening. Considering such opportunity costs as one of many factors could lead to better, more ethically sound coverage decisions. read more
August 4, 2009
August 4, 2009 > The struggle to determine how best to deal with services deemed to be marginal (offering no, or very little, benefit per cost) is perhaps the most difficult puzzle in the control of costs. Although research may find a treatment to be wasteful, a doctor or patient may think it is valuable. Policy efforts to quell the use of sound scientific research on marginal benefits threaten the classic idea of medicine as a mix of art and science. read more
July 24, 2009
July 24, 2009 > The most difficult ethical conflict in our current health care system is between those who are sick and those who profit from the sick. But some of the incomes in our system provide no social value at all; and others are surely much higher than they need to be. Until we reduce these inflated expenses, including unnecessary overhead, then lecturing the public that it must accept rationing is a recipe for political failure, and bad policy as well. read more
July 16, 2009
July 16, 2009 > The notion that health care rationing does not presently occur, and that if it did it would be wrong, are based on misconceptions of the true definition of rationing and a failure to understand the implications of not having a necessary level of rationing. read more
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Can Rationing Be Painless?