Allocating Health Care Resources

Question 1

What is the need for rationing

Answer 1

• The health care system does not have unlimited resources
  
  • Demand always exceeds supply and rather try to increase efficiency and more funding are temporary solutions

Question 2

What levels do rationing occur

Answer 2

• Between health care and other uses
  
  • Different health concerns
  • Different types of treatment
  • Different patient groups

Question 3

What is “Fair” resource allocation options

Answer 3

1. If all cant have it then none can have it
   
   • Not willing to pick one group over another
   • Resources may be left unused when benefit for some was possible
   • Equal share
     2. First come first served
   • We line up even if the service is unclear
   • Tends to favor experienced, affluent or people with connections
   • People can tend to skip or get passed the line
   • Potential delays for those with more urgent need
     3. Giving according to merit (contribution, behaviour)
   • Whoever gives more to society gets more out of it
     4. To the ability to pay
   • Free market principles
   • Let the market decide the true value of a good/ sservice and allow those willing to pay the value to receive the service
   • Those that can pay little to no delay to care (those that cant pay have little or no access to care)
   • The ones who need it the most could be priced out of the market
     5. According to need
   • Equity
   • Based on need and capacity to benefit
   • Targets groups in terms of health status (usually those most socially and economically disadvantaged)
   • Fails to consider efficiency
   • Rawls difference principle
     6. Greatest good for the greatest number (utilitarian)
   • Based on maximizing social benefit (pharmacoeconomic analysis)
   • Resources given to groups seen to get the greatest benefit
   • Fails to consider egalitarian (equality) concerns or wish to prioritize the worst off
     7. To each an equal chance
   • Based on age/ years of full health
   • Also those who have not enjoyed a high quality of life benefit
   • The fair innings concept (getting your turn at bat)
     8. Depends on what we see as fair

Question 4

What is ROR

Answer 4

• Rule of rescue
  
  • The human psyche trump the utilitarian rational that is implicit in cost effective analysis
  • We cant stand by when we see a persons life is visibly in danger if effective rescue measures are available
  • If someone is missing we look for them

Question 5

Is ROR fair

Answer 5

• Has social value
  
  • Tilts to those who we can identify with, more worthy, can create awareness (sympathy)(the young, attractive, media savvy)
  • The unknown or unsympathetic are disadvantaged even if the need is greater