Cover: The Health Care Resource Allocation Debate

The Health Care Resource Allocation Debate

Defining Our Terms

Published in: JAMA, Journal of the American Medical Association, v. 266, no. 23, Dec. 18, 1991, p. 3328-3331

Posted on on January 01, 1991

by David Hadorn, Robert H. Brook

The problem of health care distribution in the United States demands immediate action. Many different solutions have been proposed to slow rising health care costs and to improve access to care for the poor and uninsured. Debate among proponents of these various proposals might be advanced if a common language were adopted with regard to certain key terms instead of the various meanings currently assigned to these terms. For this reason, the authors propose and defend the following three definitions: (1) rationing is the societal toleration of inequitable access to health services acknowledged to be necessary by reference to necessary-care guidelines; (2) health care needs are desires for services that have been reasonably well demonstrated to provide significant net benefit for patients with specified clinical conditions; and (3) basic benefit plans are insurance packages that provide for all and only acknowledged health care needs, again by reference to appropriate clinical guidelines.

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