BMJ 1996;312:391-392 (17 February)

Editorials

Being creative about rationing

An innovatory theory helps clearer thinking

Two of the biggest questions in health care are "How much money should we spend?" and "What should we spend it on?" We don't have adequate methods for answering either question, but Ronald Dworkin, professor of law in both Oxford and New York and one of the world's leading thinkers on medical ethics, has developed a theory that provides a means to begin to answer both questions. Last week he presented his "prudent insurance principle" at a meeting in London organised by the Institute for Public Policy Research.

Current practice with health care expenditure is based--more implicitly than explicitly--on what Professor Dworkin calls "the insulation model." This postulates that health care is fundamentally different from other goods, that equality of access is essential for health care because it is so different, and that when something can be done acutely to avoid death it should . . . [Full text of this article]


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Relevant Article

Social decisions associated with rationing are not yet acceptable
Julian Tudor Hart
BMJ 1996 312: 1605. [Extract] [Full Text]

This article has been cited by other articles:

  • Stronks, K., Strijbis, A.-M., Wendte, J. F, Gunning-Schepers, L. J (1997). Who should decide? Qualitative analysis of panel data from public, patients, healthcare professionals, and insurers on priorities in health care. BMJ 315: 92-96 [Abstract] [Full text]  
  • Hart, J. T. (1996). Social decisions associated with rationing are not yet acceptable. BMJ 312: 1605a-1605 [Full text]  
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