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Rationing just medical care.

Lawrence J Schneiderman¹

¹Family and Preventive Medicine and Medicine, University of California-San Diego School of Medicine, La Jolla, CA 92093, USA. ljs@ucsd.edu

The American Journal of Bioethics : AJOB

|July 13, 2011

Summary

This study proposes a framework for rationing medical care, not healthcare, defining a "decent minimum" of treatments for equitable access. It prioritizes essential medical interventions within U.S. cultural norms.

Area of Science:

Health Policy and Economics
Bioethics and Medical Law
Public Health and Epidemiology

Background:

Current U.S. healthcare policy debates primarily focus on financing, neglecting the definition and prioritization of services.
The concept of healthcare as a commodity overlooks the need for ethical considerations in service provision and outcome prioritization.
Societal justice necessitates a discussion on rationing and defining essential medical care access.

Purpose of the Study:

To propose a rationing framework for medical care, distinct from the broader concept of healthcare.
To define a "decent minimum" of medical treatments accessible to all in a just society.
To examine the application of this rationing proposal to diabetes mellitus across the lifespan.

Main Methods:

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Development of a rationing proposal aligned with U.S. cultural and traditional values.

Definition of a "decent minimum" standard for essential medical care.

Case study analysis of diabetes mellitus management and access to care throughout life.

Main Results:

The proposed rationing model balances individual choice with societal interdependence.
A clear definition of a "decent minimum" for medical care is established.
The framework is illustrated through the life course of individuals with diabetes mellitus.

Conclusions:

A focused approach on medical care rationing, rather than comprehensive healthcare, is feasible and culturally relevant.
The "decent minimum" concept provides a foundation for equitable access to essential medical treatments.
This framework offers a structured approach to prioritizing medical interventions in a just society.