title: An overview of allocation and rationing: implications for geriatrics.
abstract: Geriatricians are faced with increasing pressure from insurers and the public to control costs. At the same time, subspecialist colleagues, patients, and the courts often demand ever more costly high-technology interventions. This conflict will only intensify given the sustained increase in the percentage of GNP spent on medical care. A number of prominent biomedical ethicists and others have explored rationing of medical care services as one response to these concerns. This is the second in a series of articles in the Journal in response to the Oregon Health Decisions Initiative and is designed to provide (1) a brief ethical perspective on rationing and allocation; (2) an analysis of our present, largely implicit, approach to rationing and allocation; and (3) some suggestions that might move the United States closer to a more coherent and reasonable means of allocating and rationing health care.
authors.affiliation: George Washington University School of Medicine, Washington, DC.
authors.forename: L G
authors.initials: LG
authors.lastname: Pawlson
authors.forename: J J
authors.initials: JJ
authors.lastname: Glover
authors.forename: D J
authors.initials: DJ
authors.lastname: Murphy
mesh_terms: D000368:Aged; D026686:Beneficence; D032921:Consensus; D003363:Cost Control; D004992:Ethics, Medical; D005260:Female; D005853:Geriatrics / Q000191:economics; D015276:Health Care Rationing / Q000191:economics; D006299:Health Services for the Aged / Q000191:economics; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D018579:Patient Selection; D011057:Politics; D040841:Resource Allocation; D012935:Social Justice; D012945:Social Values; D014481:United States