Health services throughout the world do not have enough resources to meet the healthcare needs of all of their citizens. Therefore, some form of rationing within health services is inevitable. Even within healthcare systems in which access to health care is guaranteed— however they are funded—this will mean that some who are ill will not necessarily receive treatment when they need it, if at al...

Healthcare reform and rationing have become almost household words in many Western countries, including Israel. The public, health professionals, and political leaders are united in the belief that a serious problem exists in providing comprehensive healthcare to the entire population at an affordable and politically acceptable price. It is important to preserve our sense of proportion. Most of...

Let’s start with the easier vignette: Vignette 3 illustrates the failure of the physician to discuss transition to hospice care. As the authors describe, a dying man with pancreatic cancer “had an ECOG performance status of 3 at his last visit...you were to see him again in clinic next week to discuss hospice....” Not making time for this important communication at his last visit was a tremendo...

CHAT has its limits. It is a three-hour exercise. However, the real world problems of healthcare rationing and priority-setting are too complex for a three-hour exercise. What is needed, as a supplement, are sustained processes of rational democratic deliberation that can address the challenges to healthcare justice posed by costly emerging medical technologies, such as these targeted cancer th...

In many European countries where reforms of the welfare system are underway, reference is often made to the need to ‘rationalise’ the provision of health care. This term is generally used to refer to the need to organise healthcare effectively by reducing waste, containing costs, and ensuring that budgets are adhered to. Actions taken to achieve this are varied: some relate to the provision of ...

BACKGROUND There is broad international agreement from clinicians and academics that healthcare rationing should be undertaken as explicitly as possible, and the BMA have publicly supported the call for more accountable priority setting for some time. However, studies in the UK and elsewhere suggest that clinicians experience a number of barriers to rationing openly, and the information needs o...

BACKGROUND The publicly financed health service in Sweden has come under increasing pressure, forcing policy makers to consider restrictions. OBJECTIVE To describe different perceptions of rationing, in particular, what citizens themselves believe influences their acceptance of having to stand aside for others in a public health service. DESIGN Qualitative interviews, analysed by phenomenog...

Society should not accept the inevitability of rationing medical resources, at least not in the short term. Because of the high degree of waste and duplication that characterize the Canadian and, even more, the American healthcare system, the invitation to focus on rationing procedures known to be useful is likely to divert attention from the need to eliminate waste. If and when extensive ratio...

Healthcare spending will continue to rise, not only because of inflationary drivers but as a result of growing recognition by policymakers, worldwide, that improved health is inextricably linked to greater national wealth. Keeping the universal healthcare model throughout the European Union (EU) will require rationing of services and consolidation of healthcare facilities, as public resources f...