Technical analysis is indispensable but only the start

The great rationing debate has gone into one of its quiet phases. The occasionally angry controversies of the past decade or so on have ended in something remarkably like a truce between those who saw the future in terms of improved technical analysis and those who wanted better processes for decision making.1 It is becoming increasingly apparent—and accepted—that these are complementary rather than alternative ways of tackling rationing within whole systems of health care. The technocrats and the political realists are finding common ground in the realisation that, while more information and better analysis are indeed essential, there is no once-and-for-all formula or technical fix for resolving the question of how best to allocate scarce healthcare resources. The result seems to be less interest in the theology of rationing and more emphasis on developing the methodologies of analysis and decision making.

The focus of most of this activity is …