Hostname: page-component-84b7d79bbc-x5cpj Total loading time: 0 Render date: 2024-07-30T06:54:07.424Z Has data issue: false hasContentIssue false
  • English
  • Français

Conserving Scarce Resources: Willingness of Health Insurance Enrollees to Choose Cheaper Options

Published online by Cambridge University Press:  01 January 2021

Samia A. Hurst ,
J. Russell Teagarden ,
Elizabeth Garrett  and
Ezekiel J. Emanuel
Get access Rights & Permissions [Opens in a new window]

Extract

Health care costs have been rising steadily in most industrialized countries. These increases are driven primarily by technological advances and, to a lesser degree, by aging of the population. Many factors make it unlikely that market forces alone will limit increases in the costs of health care. These unremitting increases make health care rationing appear both necessary and inevitable.One of the least controversial mechanisms for rationing could be to allow patients to make their own choices as to which kinds of care they would be willing to forgo. This is appealing because it preserves individual freedom of choice regarding health care in a way that other rationing mechanisms often do not. Rationing by patient choice, however, can only happen if patients recognize that resources are limited and need to be conserved, and are willing to forgo marginal benefits.

Type
Independent
Information
Journal of Law, Medicine & Ethics , Volume 32 , Issue 3 , Fall 2004 , pp. 496 - 499
Copyright
Copyright © American Society of Law, Medicine and Ethics 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

“OECD Health Data 2002: a Comparative Analysis of 30 Countries” CD-Rom, OECD, Paris 2002.Google Scholar
Zweifel, P. and Breyer F, F., Health Economics (Oxford, New York: Oxford University Press, 1997); Hiatt, H.H., “Protecting the Medical Commons: Who is Responsible?” N. Engl. J. Med. 293, no. 5 (1975): 235–41; Arrow, K.J., “Uncertainty and the Welfare Economics of Medical Care,” Journal of Health, Politics and Policy Law 26, no. 5 (2001): 851–83.Google Scholar
Ubel, P., Pricing Life: Why It’s Time for Health Care Rationing (Cambridge, Massachusetts: The MIT Press, 2001).Google Scholar
Hall, M.A., Making Medical Spending Decisions (Oxford: Oxford University Press, 1997).Google Scholar
Levit, K., et. al., “Trends in U.S. Health Care Spending, 2001,” Health Affairs 22, no. 1 (2003): 154–64.CrossRefGoogle Scholar
Heffler, S., et. al., “Health Spending Projections for 2002–2012,” Health Affairs Web Exclusive (February 7, 2003): W3–54 to W3–65, at <http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.54v1/DC1> (last visited August 6, 2004).CrossRef+(last+visited+August+6,+2004).>Google Scholar
Ess, S.M., Schneeweiss, S. and Szucs, T.D., “European Healthcare Policies for Controlling Drug Expenditure,” PharmacoEconomics 21, no. 2 (2003): 89–103; Jacobson, D., “Effective Strategies for Managing Pharmacy Benefits,” Healthcare Financial Management 55, no. 3 (2001): 41–2.CrossRefGoogle Scholar
Ubel, P.A. and Goold, S.D., “‘Rationing’ Health Care: Not All Definitions are Created Equal,” Archives of Internal Medicine 158, no. 3 (1998): 209–14; Eddy, D.M., “What Care is ‘Essential’? What Services are ‘Basic?’” JAMA 265, no. 6 (1991): 782, 786–8.CrossRefGoogle Scholar
Danielson, P., “Competition Among Cooperators: Altruism and Reciprocity.” Proceedings of the National Academy of Sciences of the United States of America, 99, Suppl. 3 (2002): 7237–42; Milinski, M., Semmann, D. and Krambeck, H.J., “Reputation Helps Solve the ‘Tragedy of the Commons,’” Nature 415, no. 6870 (2002): 424–6.CrossRefGoogle Scholar
Daniels, N. and Sabin, J., “Limits to Health Care: Fair Procedures, Democratic Deliberation, and the Legitimacy Problem for Insurers,” Philosophy of Public Affairs 26, no. 4 (1997): 303–50; Daniels, N., Teagarden, J.R., Sabin, J.E., “An Ethical Template for Pharmacy Benefits,” Health Affairs 22, no. 1 (2003): 125–3; Emanuel, E.J., “Patient v. Population: Resolving the Ethical Dilemmas Posed by Treating Patients as Members of Populations,” in Danis, M., Clancy, C.M. and Churchill, L. L., eds. Ethical Dimensions of Health Policy (Oxford, New York: Oxford University Press, 2002): 227–245.CrossRefGoogle Scholar
Leibowitz, A., Manning, W.G. and Newhouse, J.P., “The Demand for Prescription Drugs as a Function of Cost-Sharing,” Social Science and Medicine 21, no. 10 (1985): 1063–9; Rector, T.S., et. al., “Effect of Tiered Prescription Co-payments on the Use of Preferred Brand Medications,” Medical Care 41, no. 3 (2003): 398–406; Motheral, B. and Fairman, K.A., “Effect of a Three-Tier Prescription Copay on Pharmaceutical and Other Medical Utilization,” Medical Care 39, no. 12 (2001): 1293–304; Motheral, B., Henderson, R., “The Effect of a Copay Increase on Pharmaceutical Utilization, Expenditures, and Treatment Continuation,” American Journal of Managed Care 5 (November 1999): 1383–94.CrossRefGoogle Scholar