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Special Reports on  " General Science"

      Click on a title below to access the article in this Special Report.

Special Reports

Health-Care Rationing?

"Rationing" is the unspeakable idea in the health-care debate, yet it already occurs, largely according to ability to pay. Are there fairer ways of allocating medical resources?
Illustration by Marcia Klioze Hughes/The World & I 

Introduction
The arrival of highly advanced, complex--and increasingly expensive--technology and medical techniques has transformed health care in the ...

What's Missing From the Medical Reform Debates?
The 1994 debates over medical-care reform created more controversy than any issue in recent memory. They have been the subject of thousands of newspaper articles and news reports, and have been the subject of discussion for millions of people, and yet have had very little to do with actually reforming the medical-care industry, changing the type of treatment patients will receive, or reducing the cost of medical services. Congressional debates have centered on the need and desirability of universal insurance coverage paid by employers and the need and desirability of government control over the industry. Future congressional resolution of either or both of these issues with the passage of a reform bill will be hailed as a major step forward by the Clinton administration, but in reality it will not solve fundamental medical-care problems. ...

A Sense of Limits in Health Care
The "rationing" of health care has come to mean the explicit exclusion of some available and potentially beneficial medical treatments from a benefit package through nonfunding. Rationing arises in the tension between limited resources and virtually unlimited health-care expectations. Any rationing system, no matter how appealing in the abstract, is a hard pill to swallow when one's own life or the life of a loved one is on the line. Even if limits on health-care expenditure are agreed to in principle by subscribers to a health-care plan, it is hard for physicians to tell a patient that these limits apply to him or her. ...

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