Reforming the health care system for children and the elderly to balance cure and care.
There is now a great disparity in the United States between resources going to the young, the nation's poorest age group, and to the elderly, the wealthiest age group, who are absorbing a greater and greater share of resources for health care. The author outlines reasons that these imbalances in the groups' access to resources have developed, and then demonstrates that, in the area of health care reform, an entitlement program for the young is not the answer: society must overcome its unwillingness and put into place a universal health care system. Even with such a system, the health care needs of the elderly will continue to grow and absorb more resources, both because the percentage of elderly is rising and because developments in medical technology continue to create new treatment possibilities and expectations. Should the health care needs of the elderly be allowed to absorb a more and more disproportionate share of the nation's resources compared with the resources used for the young? The author answers "No" and explains why he thinks (1) that medicine should become more oriented toward providing care, preventing premature death, and improving the quality of people's lives for a reasonable span of years (for example, until 80) and less toward saving lives of the very old and incurably ill at great cost; (2) that rationing and priority setting are inevitable because of limited resources; and (3) that the claims of children may on occasion need to be placed before those of the elderly. These changes can be made only if Americans change their health care system and some of their present values about the role of medicine.
Callahan
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Hastings Center, Briarcliff Manor, New York 10510.
D000368:Aged; D002648:Child; D002662:Child Health Services / Q000592:standards* / Q000639:trends; D035082:Federal Government; D015276:Health Care Rationing / Q000592:standards* / Q000639:trends; D006295:Health Resources / Q000592:standards / Q000639:trends; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends; D006301:Health Services Needs and Demand / Q000592:standards* / Q000639:trends; D006299:Health Services for the Aged / Q000592:standards* / Q000639:trends; D006801:Humans; D009310:National Health Insurance, United States; D011203:Poverty / Q000706:statistics & numerical data; D014481:United States