Allocating Health Care Resources PDF
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ALLOCATING HEALTH CARE RESOURCES BIOMEDICAL ETHICS REVIEWS Edited by James M. Humber and Robert F. Almeder BOARD OF EDITORS William Bechtel Thomas H. Murray Georgia State University Case Western Reserve University Atlanta. Georgia Cleveland, Ohio William J. Curran James Muyskens Harvard School of Public Health University of Kansas Boston, Massachusetts Lawrence, Kansas Kurt Hirschhom James Rachels The Mount Sinai Medical Center University of Alabama New York, New York Birmingham, Alabama Richard Hull Richard Wasserstrom State Univ. of New York, Buffalo University of California Amherst, New York Santa Cruz, California BIOMEDICAL ETHICS REVIEWS • 1 9 9 4 • ALLOCATING HEALTH CARE RESOURCES Edited by James M. Humber and Robert F. Almeder Georgia State University, Atlanta, Georgia * Springer Science+Business Media, LLC Copyright© 1995 by Springer Science+Business Media New York Originally published by Humana Press lnc. in 1995 Softcover reprint of the hardcover 1st edition 1995 Ali rights in any form whatsoever reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopy ing, microfilming, recording, or otherwise) without written permission from the publisher. This publication is printed on acid-free paper. G> ANSI Z39.48-1984 (American National Standards Institute) Permanence of Paper for Printed Library Materials. Photocopy Authorizatlon Pollcy: Authorization to photocopy items for interna! or personal use, or the interna! or personal use of specific clients, is granted by Springer Science+Business Media, LLC provided that the base fee of US $4.00 per copy, plus US $00.20 per page, is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license from the cec, a separate system of payment has been arranged and is acceptable to Springer Science+Business Media, LLC . The fee code for users of the Transactional Reporting Service is: [07 42-1796/95 $4.00 + $00.20]. 10987654321 The Library of Congress has cataloged this serial title as follows: Biomedical ethics reviews-1983-Totowa, NJ: Humana Press, c1982- v.; 25 cm-(Contemporary issues in biomedicine, ethics, and society) Annual. Editors: James M. Humber and Robert F. Almeder. = ISSN 0742-1796 Biomedical ethics reviews. ISBN 978-1-4757-4479-8 ISBN 978-1-59259-447-4 (eBook) DOI 10.1007/978-1-59259-447-4 1. Medical ethics-Periodicals. 1. Humber, James M. 11. Almeder, Robert F. III. Series. [DNLM: Ethics, Medical-periodicals. W1 8615 (P)] R724.B493 174'.2'05-dc19 84-640015 AACR2 MARC-S Contents vii Preface viii Contributors 1 Better Health Care Through Rationing Governor Richard D. Lamm 21 The Ethics of Health Care Rationing as a Strategy of Cost-Containment Lawrence W. White and Mary Ellen Waithe 55 Rationing, Rhetoric, and Rationality: A Review of the Health Care Rationing Debate in America and Europe Robert Baker 85 An Evaluation of Clinton' s Health Care Proposal George W. Rainholt 121 Health Care Allocation: A Deflationary Account ]ohnDouard 145 Hypothetical Choice Approaches to Health Care Allocation Madison Powers 177 Sin Taxes as a Mechanism of Health Care Finance: Moraland Policy Considerations ]effrey Kahn V vz Contents 203 The lnjustice of Age Bias Against Children in Allocating Health Care Loretta M. Kopelman 221 Index Preface Biomedical Ethics Reviews •1994 is the twelfth annual vol ume in a series of texts designed to review and update the Iitera ture on issues of central importance in bioethics today. Given the current debate over health care reform, the topic that has been selected for discussion in the present volume, viz., Allocating Health Care Resources, is especially timely. When selecting articles for inclusion in this volume, we, the editors, have interpreted the discussion topic most broadly; thus, the reader will find that the essays in this text deal with a wide variety of specific issues related to the allocation of health care resources. We believe this diver sity of perspective and approach strengthens our text, and we hope our readers agree. There is one significant difference between the format adopted in Biomedical Ethics Reviews • 1994 and that used in earlier volumes of our series. In the past we wrote synopses of all the articles included in a particular text and then used the compi lation of those abstracts as a general introduction for the book. In this volume of Biomedical Ethics Reviews we have abandoned that practice. Instead of having a general introduction for the text as a whole, we have seen to it that each article is prefaced with an abstract that summarizes the contents of that article. We believe this change constitutes an improvement that will facilitate study; however, if our readers find that this is not the case we would appreciate hearing from them. ]ames M. Humber Robert F. Almeder vii Contributors Robert Baker • Department ofPhilosophy, Union College, Schenectady, New Y ork lohn Douard • Institute for the Medical Humanities, University of Texas Medical Branch at Galveston, Texas ]effrey Kahn • Center for the Study ofBioethics, Medical College of Wisconsin, Milwaukee, Wisconsin Loretta Kopelman • Department of Medical Humanities, East Carolina University School of Medicine, Greenville, North Carolina Governor Richard D. Lamm • Center for Public Policy and Contemporary Issues, University of Denver, Colorado Madison Powers • Kennedy Institute of Ethics, Georgetown University, Washington, DC George Rainholt • Department of Philosophy, Georgia State University, Atlanta, Georgia Mary Ellen Waithe • Department ofPhilosophy, Cleveland State University, Cleveland, Ohio Lawrence White • Meridia Hilcrest Hospital, Cleveland, Ohio Vlll Editor's Introduction Richard D. Lamm, the former govemor of Colorado, begins discussion in "Better Health Care Through Rationing" by insist ing that the present health care delivery system in the United States cannot be sustained. In the course of his essay, Lamm delineates several factors that have helped medical costs in the United States to spiral out of control, and he argues that the only way to get health care spending under control is through ration ing. Since Lamm believes that rationing is inevitable, he insists that public policy discussion of how this rationing should pro ceed is long overdue. Finally, Lamm claims that an open discus sion of rationing should not be seen as a fearsome thing; since just as the debate over energy conservation ultimately pro duced better insulated houses and more efficient cars, so too a debate over health care rationing can Iead to improvements in the present system.
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