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Should Medical Care be Rationed by Age?

Should Medical Care Be Rationed by Age

Yet as some of us have discovered, to suggest that age itself be used as a standard for the rationing or limiting of care is an invitation to opprobrium. Thus it is hardly surprising that the papers collected in Timothy M. Smeeding's Should Medical Care Be Rationed by Age? go at their topic with the kind of anxious care that novice snake handlers must bring to their art. The result is that none of the papers gives an altogether straight answer to the question posed by the book's title.

The question is instead quietly transmuted by most of the authors into the different and more benign (if also vexing) issue of appropriate care for individual elderly patients and the efficiency of the health care system. As such it is a valuable book, one of the few that even comes near the issue of rationing health care for the elderly. In their summary of the issues raised in the volume, John M. Bunker and Bruce M. Landesman nicely catch the kind of tentativeness that marks the papers: "...all agree that we need much more data before we can be sure how great an effect reducing waste will have. In the meantime, we must be ready for the possibility that we cannot have everything we want, and that some form of health care rationing is inevitable."

But after many years of waiting for such data to appear, is it perhaps just more wishful thinking to hope that it will bring some revelatory clarity? And just how much more data do we need? The failure to date of the many and varied cost-containment ventures already tells us more than we may like to hear.

There is of course no direct way to prove that hopes for a benign solution to a difficult problem are nothing more than wishful thinking. That possibility might be confirmed only when a policy proves itself a failure but is pursued anyway. We can only look to specific policies being proposed or pursued to see whether they will fare well. Can they work? Two other recent books lay out some interesting agendas.
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Author:Callahan, Daniel
Publication:The Hastings Center Report
Article Type:Book Review
Date:Apr 1, 1988
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