Rationing 'necessary, inevitable'

Dr. Manoj Jain, an infectious-disease specialist and an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atanta, writes in The Washington Post that not only does healthcare rationing occur more often than we as patients would like to think, but that it also is a necessity in today's society.

Jain uses examples of ethical rationing - an 80-year-old smoker denied a lung transplant--and monetary rationing--an HIV patient only being allocated a certain number of medicine due to limited state funding--to strengthen his argument, but also points to uninsured Americans as another example.

"[47 million is] the approximate number of uninsured Americans, and every uninsured patient is an admission by society that we don't commit the money to provide care to people," he says. "The paradox of rationing is that it seems fair, just and equitable, and it makes sense when applied to a population. But when it applies to my patient or my mother, it makes me uncomfortable. That said, rationing is necessary and inevitable."

What makes this conundrum even more complicated, according to Jain, is that many doctors don't want to take responsibility. Some physicians simply want policies created and rules to follow, all while patients are clamoring for those same doctors to serve as "advocates." Jain suggest that a "national independent institution" to determine what will and won't be paid for in terms of cost-effective treatments could be a start. 

To read more of Dr. Jain's opinion on rationing:
- read this Washington Post article

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