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YourDoctorintheFamily.com |
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DrRich's Grand Unification Theory of Health Care - Contents - SECTION 1 - The importance of the doctor-patient relationship and why we can't have it anymore SECTION 2 - The truth about health care rationing SECTION 3 - Health Care 2000 - how it got this way SECTION 4 - Secrets of managed care SECTION 5 - Portrait of a modern HMO SECTION 6 - The Clintonians Strike Back SECTION 7 - Rationing and Death - Covert rationing and end-of-life care SECTION 8 - Fixing our health care system
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The open rationing of health care (i.e., adopting an official public policy requiring the rationing of health care, and an official methodology for conducting that rationing) tends to be a very scary prospect. It certainly scares the bejeebers out of those who ought to be discussing it publicly – economists, health policy experts, politicians, and medical thought leaders.
The scariest thing for public officials about initiating a discussion on rationing is the prospect of having to admit that we need to ration in the first place. It may not be very long, however, before some smart politician figures out that the roiling public discontent with the current health care system, a discontent that is growing every day, is at its root caused by covert rationing. And perhaps an increasingly angry public is almost ready to listen to a logical explanation of what’s really causing all the problems within our health care system.
If the day arrives when the public finally understands that rationing is already happening, and will continue to happen no matter what, then (after they’ve strung up a few hundred public officials) they may even be ready to listen to a well-formulated proposal on open rationing. To gain the support of the public, however, such a proposal would have to provide substantial benefits, and those benefits would have to be clearly articulated.
Before embarking on a discussion of what those benefits might be, we need to list six basic principles that must be taken into account by any system of open rationing. Unless these principles are explicitly considered and decided upon, open rationing would likely end up being as bad, if not worse than covert rationing.
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Principles
for designing a system of open rationing Principle 1: The goals of health care (and therefore the scope of services that society expects from the health care system) are clearly spelled out. Principle 2: The amount of money that society spends on health care is decided upon in an open process that prioritizes health care services in relation to all other essential public services. Principle 3: As many rationing decisions as possible are left to the patients who are directly affected by those decisions. Principle 4: Coverage for essential health care services is universal to all Americans. Principle 5: The rules for rationing are determined through an open, public process, and are made as explicit and as clear as possible. Principle 6: Prioritizing health care services for inclusion in the universal health plan is done according to clearly articulated ethical standards. |
Soon, we’ll examine these six principles more closely, and discuss why they are so vitally important in designing a rationing plan. Right now, let’s examine what we stand to gain in the first place by adopting such a rationing plan.