National Health Care: Law, Policy, Strategy

By Donald L. Westerfield | Go to book overview

12
Rationing Policies and Strategies

The previous chapter ended with a statement that we would not need to ration health care if we were willing to devote enough of our existing resources to solve the problem. That statement would be true if we all had a common perception of the "health care problem" and what it encompasses. Congress has not been able to formulate an acceptable state of the nature or scope of the health care problem. Special interests, business and industry, the underclass, the health care payers and providers, the insurers, and every other major stakeholder group has a different perception of the health care problem.1 Lacking a clear consensus view of the problem, it would seem reasonable to argue that everyone should be entitled to at least some basic level of health care.

How do we handle the problem of persons with incurable diseases, or underweight babies that are predicted to live no more than a few weeks or months, or those with terminal illnesses, or those who need organ transplants, or those in persistent vegetative (so-called "brain dead") conditions? These problems require remedies that go beyond a basic level of care. The previous chapter indicated that in the United Kingdom medical care above some basic level may go unprovided in given circumstances.2 Can Americans cope with making the decisions required to give more medical care to some and less to others? Almost everyone would agree that rationing in America is a certainty, as it is in every other country. Unlimited access and care for everyone is improbable and imprudent.3

-143-

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National Health Care: Law, Policy, Strategy
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Figures and Tables xi
  • Preface xiii
  • Part I - National Health Care Issues 1
  • 1 - Introduction 3
  • Notes 11
  • 2 - The Uninsured and Underinsured 13
  • 3 - Underwriting, Impaired Risks," and Pooling" 29
  • 4 - Play or Pay" and Subsidies" 43
  • Part II - Health Care Proposals in Congress 53
  • 5 - Major Universal" Plans in Congress" 55
  • 6 - Pay-or-Play" Proposals in Congress" 67
  • 7 - Health Care Reform Proposals in Congress 79
  • Part III - Special Interests, the Law and Political Posturing 91
  • 8 - Special Interests and Legislation 93
  • Notes 100
  • 9 - The Law--Federal Mandates 103
  • 10 - Obstacles Faced By Small Businesses 115
  • Part IV - National Policy and Strategies 127
  • 11 - Other National Models 129
  • Notes 140
  • 12 - Rationing Policies and Strategies 143
  • Part V - A National Health Care Plan 151
  • 13 - Workers Compensation 153
  • 14 - Proposed National Health Care Plan 161
  • 15 - Between Now and 2000 A.D. 171
  • Bibliography 177
  • Index 197
  • About the Author *
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