What are your thoughts on healthcare rationing? Do you agree or disagree
with the concept?
What type of rationing would you support in the United States? What are the
other alternatives (as you see it) if you do not support rationing?
What are your thoughts about rationing of healthcare in other countries?
Current Issues and Trends
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Institution
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Current Issues and Trends
Healthcare Rationing
Healthcare rationing refers to the process of limiting the availability of medical services for several populations. Health rationing can occur at four levels which are health care policy-makers, healthcare providers, healthcare managers, and patients. Healthcare rationing in the United States occurs in various forms like limited access to various types of healthcare services or healthcare providers. Another way that healthcare rationing presents in the US is through an increase in the barriers to healthcare, which aims at discouraging the use of expensive care while there is less expensive care or better still if the care being requested is not medically necessary. I do not agree with healthcare rationing in the US. I believe that individuals should be given the platform to access the type of care that they want or even have access to.
In the United States, limiting access to types of care or providers may include pre-authorization requirements from the health insurer, drug formularies, the requirement of a referral from the primary care physician, and restrictive provider networks. Barriers to care as a measure of healthcare rationing may take the form of cost-sharing and charging for health insurance. Increasing deductibles, copayment requirements, and coinsurance rates are likely to make it harder for the consumers of healthcare to access care due to limitations of monetary resources.
The Type of rationing that I would Support
The type of rationing that I would support is at the fourth level, which involves the politicians, the policymakers, and the health insurance companies. Rationing at this level would be based on the set rules and regulations on the allocated healthcare budget, and cost-sharing mechanisms in consideration of the economic, social, political, and technological factors (Kellidar et al., 2017). The United States healthcare system is tax-based where the government authorities practice healthcare rationing via payroll, premium-based health systems, and private or social insurance companies dealing with the rationing decisions.
The policymakers and the politicians play the roles of health stewards of the national resources, they plan and direct any healthcare-related rationing and most importantly have the mandate to choose the fairest health system, which allows the unlimited use of health resources to deliver the best healthcare outcomes. The involvement of the legislators in decision-making related to healthcare rationing ensures that the medical professionals do not enjoy the monopoly of power in decision-making without understanding the budgetary allocations and resource availability (Kellidar et al., 2017).
It is important to note that healthcare is a right and should be accessible to all. Therefore, the healthcare services should be distributed rationally to fit the needs of the people that need them. Therefore, it would be logical to limit healthcare resources to the less needy people while availing the resources to those with urgent patient needs. Rationing at the macro-level by the policymakers and politicians can apply a myriad of methods like payment mechanisms; budgets and benefits packages to control and manage the behavior of the healthcare managers to limit the provision of inappropriate and unnecessary healthcare services.
Healthcare Rationing in Other Countries
Healthcare rationing is not only a common scenario in the United States but also in other countries such as Norway and the UK. In Norway, healthcare rationing is included in the public policy as a way for the country to retain its egalitarian welfare state. A government white paper that dates back to 2016 consists of priority setting a criterion for the healthcare sector that includes health benefits, resource use, and severity of the disease (Brendbekken et al., 2022). Healthcare rationing in Norway has attracted controversy surrounding the decision-making process, the role of the healthcare players such as physicians, and public participation especially on issues such as treatment for rare diseases long wait for discussions on drug use on populations, unapproachable decision-makers, and patients’ rights violations. Brendbekken et al. (2022) assert that the issue of healthcare rationing in Norway is a conversation between the stakeholders in the sector and the decision-makers a change from the previous bureaucratic and secretive process that existed years ago.
In the United Kingdom, healthcare rationing is prevalent among patients seeking non-emergency treatment. Healthcare rationing on the NHS operations has been attributed to overspending in the healthcare sector. The pressure to cut the costs of care has resulted in the need for providers to restrict the provision of some services or the dilution the quality of the care provided to patients. Some NHS operations that have been affected by rationing include hip and knee surgeries, cataract surgeries, as well as access to drugs for the management of conditions like arthritis.
Healthcare rationing is a policy adopted by governments to curb healthcare spending while at the same time regulating the access and spending of healthcare resources. However, decisions related to healthcare rationing should be reached with consideration of a myriad of factors and the involvement of stakeholders from the health sector and policymakers. The population should have access to healthcare services and products with minimal barriers since healthcare is a human right.
References
Keliddar, I., Mosadeghrad, A. M., & Jafari-Sirizi, M. (2017). Rationing in health systems: A critical review. Medical journal of the Islamic Republic of Iran, 31, 47. https://doi.org/10.14196/mjiri.31.47
Brendbekken, A., Robberstad, B., & Norheim, O. F. (2022). Public participation: healthcare rationing in the newspaper media. BMC health services research, 22(1), 1-14.