A process of withholding goods or services when they are in short supply. Rationing of health care is, of course, in one sense in effect, since it is not possible to provide all the care which has been proven effective to all the individuals who might benefit from it. In the climate of health care reform, discussion revolves around the problems of deciding the basis on which the limited financial and other resources will be allocated; on who will get what care there is. One method of rationing is financial: when the money runs out the care stops. This is first-come first-served. Another rationing method is to identify certain groups of patients, such as Medicare and Medicaid, as eligible for the benefits. Other methods have been proposed, such as cutting benefits off on the basis of age. Perhaps the most scientific and fair method proposed is the “Oregon plan” in which there is an explicit list of patient-care “problem-treatment (diagnosis-treatment) pairs,” ranked as to their benefits to the individuals and to society. Those most beneficial, ranked highest, are funded first, and actuarial methods determine how far down the list the available funds will go. A line is drawn at that point, and lower ranked services are not paid for from the given fund source.
Resource allocation in health care, especially in managed health care systems.