Rationing of health care--who determines who gets the cure, when, where, and why?

Prioritising, Ranking and Resource Implementation - A Normative Analysis

Background Priority setting in publicly financed healthcare systems should be guided by ethical norms and other considerations viewed as socially valuable, and we find several different approaches for how such norms and considerations guide priorities in healthcare decision-making. Common to many of these approaches is that interventions are ranked in relation to each other, following the appli...

The Why, Who, What, How, and When of Patient Engagement in Healthcare Organizations: A Response to Recent Commentaries

From an ethics of rationing to an ethics of waste avoidance.

n engl j med 366;21 nejm.org may 24, 2012 1949 distributive justice. But in the United States, ethical debate is now shifting from rationing to the avoidance of waste. This little-noticed shift has important policy implications. Whereas the “R word” is a proverbial third rail in politics, ethicists rush in where politicians fear to tread. The ethics of rationing begins with two considerations. ...

Ethics and health care 'underfunding'.

There are continual “crises” in health care systems worldwide as producer and patient groups unify and decry the “underfunding” of health care. Sometimes this cacophony is the self interest of profit seeking producers and often it is advocacy of unproven therapies. Such pressure is to be expected and needs careful management by explicit rationing criteria which determine who gets access to what...

Aging, Pensions and Long-term Care: What, Why, Who, How?; Comment on “Financing Long-term Care: Lessons From Japan”

Japan has been aging faster than other industrialized nations, and its experience offers useful lessons to others. Japan has been willing to expand its welfare state with a long-term care (LTC) insurance to finance home care and nursing home care for frail elderly. As Ikegami shows, it created new facilities and expanded specialized staffing for home care, developed a c...