NCPA - National Center for Policy Analysis

Health Care Reform Through Rationing

October 13, 2003

Rationing is probably in the future for the U.S. health care system, says University of Alabama student Elizabeth J. Floyd.

In the Journal of Healthcare Management, she outlines several proposals for rationing health care. Among her proposals:

  • Develop a national program in which some health services are withheld from Medicaid beneficiaries, and the funds are saved and redirected to provide broader coverage to all those under the poverty line.
  • Use quality-adjusted life years (QALY), and provide care to those who have the greatest capacity to benefit from it, while denying care to those who are not likely to benefit.
  • Promote consumer self-rationing by encouraging them to watch their use of health care and become more aware of unnecessary and unneeded procedures.
  • Encourage health care providers to actively and openly participate in bedside rationing.

While some of these proposals are controversial and may raise concerns about ethics, Floyd says that health care has become so expensive in the United States that ensuring full access to services for all people is simply not feasible without some form of rationing.

Source: Elizabeth J. Floyd, "Health Care Reform Through Rationing," Journal of Healthcare Management, July/August 2003.


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