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Detoxifying the concept of rationing
1Harvard Medical School, Department of Population Medicine, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 USA. jim_sabin@harvardpilgrim.org.
Insights
Clinicians must lead discussions on healthcare rationing to control rising costs. Andrew Hantel
Area of Science:
- Healthcare economics
- Medical ethics
- Health policy
Background:
- The U.S. faces escalating healthcare costs.
- Cancer drug shortages highlight the need for resource allocation discussions.
- Political barriers prevent top-down healthcare budgeting and rationing decisions.
Purpose of the Study:
- To advocate for clinician-led discussions on healthcare rationing.
- To propose a framework for ethical healthcare rationing.
- To address the challenge of healthcare cost escalation in the U.S.
Main Methods:
- Analysis of Andrew Hantel's proposal for managing cancer drug shortages.
- Argument for the necessity of healthcare budgets and rationing.
- Examination of the role of health professionals in public education.
Main Results:
- Clinician-led initiatives, like Hantel's, can foster necessary discussions on rationing.
- Public acceptance of rationing as an ethical necessity is crucial for cost control.
- A bottom-up educational approach by health professionals is viable in the absence of political leadership.
Conclusions:
- Healthcare rationing, when implemented ethically, is essential for managing costs.
- Health professionals are pivotal in educating the public and driving change.
- Addressing healthcare cost escalation requires a shift towards budget-based systems and acceptance of rationing.
Abstract:
Andrew Hantel's proposal for dealing with cancer drug shortages exemplifies the kind of clinician-led discussion of rationing the U.S. political process requires. I argue that the U.S. will not get a grip on healthcare cost escalation until we set true budgets for healthcare. We will not be able to do that until the public accepts that rationing, done right, is an ethical necessity, not an ethical abomination. Because endorsing rationing is a third rail for politicians, "top down" leadership is currently impossible. As a result, health professionals must lead a "bottom up" educational process. Hantel shows how this can be done.
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