Can We Say No?: The Challenge of Rationing Health Care

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Brookings Institution Press, Nov 21, 2005 - Medical - 199 pages
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Over the past four decades, the share of income devoted to health care nearly tripled. If policy is unchanged, this trend is likely to continue. Should Americans decide to rein in the growth of health care spending, they will be forced to consider whether to ration care for the well-insured, a prospect that is odious and unthinkable to many. This book argues that sensible health care rationing can not only save money but improve general welfare and public health. It reviews the experience with health care rationing in Great Britain. The choices the British have made point up the nature of the options Americans will face if they wish to keep public health care budgets from driving taxes ever higher and private health care spending from crowding out increases in other forms of worker compensation and consumption. This book explains why serious consideration of health care rationing is inescapable. It also provides the information policymakers and concerned citizens need to think clearly about these difficult issues and engage in an informed debate.

 

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Contents

The Promise and the Problem
1
The British System
11
Matters of Life and Death
30
Quality of Life
59
Diagnoses
77
Rationing and Efficiency
93
Efficiency and Inefficiency in British Health Care
108
Rationing Health Care in the United States
131
Frequency of Surgery
149
Notes
155
Index
195
Back Flap
202
Back Cover
203
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About the author (2005)

Henry J. Aaron is a senior fellow in Economic Studies at the Brookings Institution, where he holds the Bruce and Virginia MacLaury Chair. Among his many books are Can We Say No? The Challenge of Rationing Health Care, with William B. Schwartz and Melissa Cox (Brookings, 2006), and Reforming Medicare: Options,Tradeoffs, and Opportunities, written with Jeanne Lambrew (Brookings, 2008). William B. Schwartz is an expert on national health policy and is a professor of medicine at the University of Southern California. He was formerly chairman of the Department of Medicine and Vannevar Bush Professor at Tufts University and was also president of the American Society of Nephrology. Melisssa Cox is a student at Yale Law School.

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