Healthcare regulations should guarantee that everybody has access to appropriate healthcare. The main goals for healthcare are: Equal access to health care for everyone; Cost-efficient production of health services and Cost-control of public expenditure for medical services. Especially cost-control seems to be a global problem. One of the key issues in the debate on how to improve healthcare is rationing. It is an important challenge to understand the various methods of rationing in medical care, to analyse the effects of rationing and the ways to harmonize the various rationing cultures in Europe. This publication gives a comprehensive overview of the perception of different population groups in an international context and it shows how the different population and occupational groups estimate the possibilities, forms and also limits rationing in the near future. Patients who are affected by rationing decisions could ask for treatment in foreign European countries. In order to limit social inequities caused by capacity problems in less rationed countries it is important in a first step to demonstrate the differences in rationing procedures between European countries.

The book series on the ethics of science and technology assessment edited by the Europ?ische Akademie is devoted to the publication of the work-reports of its project groups, works on the foundations of ethics, the philosophy science, and other issues related to the work of the Europ?ische Akademie. In addition, the series comprises the proceedings of conferences organized by the academy. The 13th volume documents the proceeding of the academy's spring symposium in 2000 on Rationing in Medicine which was held in Bad Neuenahr-Ahrweiler on March 23-25, 2000. An intense discussion on the future of health care in Europe has been stimulated by increasing difficulties of securing adequate and needs orientated medical care in the face of scarce resources and medical progress. Un fortunately, quite of ten a rational discussion of rationing is drowned out by the politic al talk of the day. But only an open and well-informed debate, if anything at ali, can lead to transparent and just rationing procedures which eventually might be acceptable to the public at large. For this debate much can be learnt from observing the experiences other countries have made with their health care arrangements. What kinds of mistakes should be avoided and what might be useful in the different states and perhaps also in the supra-national context of an emerging Europe are interesting and important issues.

The National Health Service provides poor quality health care, compared with systems in other developed countries. In this book, Heinz Redwood makes detailed comparisons between the UK, France, Germany and the USA, in order to demonstrate just how wide the gap between Britain and the rest of the developed world has become. We spend less of our national wealth on health than countries at a similar level of economic development. In terms of numbers of doctors and nurses, the UK is closer to Mexico and Turkey than it is to France and Germany. As a result, we find ourselves denied the standard of care which people in other countries take for granted, or else we wait so long that some patients die before reaching the head of the queue.

The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.

"Examines the use of rationing as a means to curb health care spending, using the experience of Great Britain to highlight the promises and pitfalls of this approach"--Provided by publisher.

This volume contributes to the ongoing debate about healthcare rationing by bringing together case studies of resource allocation at different levels of the healthcare system. Drawing on research from the United Kingdom, Europe and North America, it examines issues such as prioritisation and access to care in a range of hospital and community settings.

Health systems need to set priorities fairly. In one way or another, part of this important task will fall to physicians. How do they make judgments about resource stewardship, and how should they do so? How can they make such decisions in a manner that is compatible with their clinical duties to patients? In this book, philosophers, bioethicists, physicians, lawyers and health policy experts make the case that priority setting and rationing contribute significantly to the possibility of affordable and fair healthcare and that clinicians play an indispensable role in that process. The book depicts the results of a survey of European physicians about their experiences with rationing and other cost containment strategies, and their perception of scarcity and fairness in their health care systems. Responding to and complementing these findings, commentators discuss why resource allocation and bedside rationing is necessary and justifiable. The book explores how bedside rationing relates to clinical judgments about medical necessity and medical indications, marginal benefits, weak evidence based medicine, off-label use. The book highlights how comparative studies of health care systems can advance more effective and fair bedside rationing through learning from one another. From a practical standpoint, the book offers a number of strategies for health care systems and clinicians to work in tandem to allocate and ration resources as fairly as possible: how to foster more attention to fairness when rationing at the bedside, how to avoid exacerbating health disparities when allocating resources, how to teach about bedside rationing to students, how to discuss rationing more explicitly in the public arena and in the doctor's office.