Rationing health care

"One of the most controversial issues in many health care systems is health care rationing. In essence, rationing refers to the denial of - or delay in - access to scarce goods and services in health care, despite the existence of medical need. Scarcity of financial and medical resources confronts society with painful questions. Who should decide which medicine or new treatment will be covered by social security and on which criteria such decisions must be based? Can age, for example, be justified as a selection criterion? Should decision-making be left to health care policymakers, hospital administrators, or rather, to treating physicians ('bedside rationing')? And finally: is there a role for individual patients? There are the difficult questions that suggest the need for transparent and democratic decision-making. In reality, however, the rationing debate occurs in a sub rosa world, based on imperfect information, distorted interpretations of effectiveness, and hidden cost concerns. Rationing Health Care : Hard Choices and Unavoidable Trade-offs explores these and other questions from various perspectives (medicine, philosophy, ethics, economics and law)--P. [4] of cover.