[Increasing inequality in health care by separating medical indication from financial responsibility].
Guidelines for clinical practice have as their primary aim to improve that practice. However, the increasing flow of medical technology threatens to exhaust the financial reserves. There is now an undeniable conflict between what can be done and what can be paid for. This leads to a conflict between the responsibility of the caregiver for the individual patient and for society. Either available care is denied or health insurance is ruined. This inevitably leads to increasing inequality: only the better off can afford a therapy which is effective but not efficient. The individuals right to health care can never entirely be reconciled with the societal imperative for a more just distribution of financial resources. Guidelines which are a result of a bargain between all stakeholders are therefore more just: they are a compromise between the rights of the individual and those of the society. The legal status of guidelines should be reinforced.
Bonneux
L
L
Erasmus Universiteit, Instituut Maatschappelijke Gezondheidszorg, Rotterdam. bonneux@mgz.fgg.eur.nl
D003362:Cost-Benefit Analysis; D004470:Economics, Medical / Q000639:trends*; D005102:Health Expenditures; D006285:Health Planning; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D009426:Netherlands; D017410:Practice Guidelines as Topic