title: Rationing health care: it's a matter of the health care system's structure.
abstract: The article examines two primary policy proposals for how the U.S. should allocate its limited health care dollars: a centralized model in which a commission establishes rationing guidelines, and a decentralized model in which rationing decisions are made by health care providers on a case by case basis. The author finds significant advantages with each position, leading the author to assert that a combination of each is key to an effective rationing policy: a centralized control of structure coupled with decentralized physician-level decision making. While mindful that formal rationing guidelines alone are unfeasible to effectuate cost-effective care, the author introduces two decentralized policies to control costs: the limitation of resources at physicians' disposal and elimination of physicians' personal incentive to provide high-cost care.
authors: Hall Center for Law and Health at Indiana University School of Law, Indianapolis, USA.
authors: David
authors: D
authors: Orentlicher
mesh_terms: D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D015276:Health Care Rationing / Q000458:organization & administration*; D017146:Models, Organizational; D011050:Policy Making; D014481:United States