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End the duopoly

Rationing of healthcare before, during and after COVID-19

Early in the COVID-19 pandemic, it became evident the United States would face difficult resource allocation decisions . Projected shortages of ventilators and beds in hospital intensive care units prompted frameworks for rationing scarce healthcare resources during a public health emergency. These frameworks incorporated several guiding ethical values. Yet, none suggested rationing based on an individual’s ability to pay for care.

In the pandemic context, there is widespread agreement that the ability to pay is not an ethically appropriate way to determine who receives care. But, what about under normal circumstances?

Acute instances in which demand exceeds a finite supply of a product, such as a ventilator, certainly call for a specialized response. However, while rationing decisions might not always be as stark as the expected ventilator shortage, they consistently occur. Rationing occurs in every healthcare system, including in the United States.

All resources are scarce. This concept is built into common definitions of the subject of economics. The nation’s healthcare resources must be allocated among patients in need according to either explicit or implicit criteria.

The rationing frameworks espoused during the pandemic demonstrate some of the various ways in which healthcare can be, and is, rationed by healthcare systems in other countries […]

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