Healthcare and other specialists also discuss physician Medicare fraud, continuous improvement in public reporting, what Canada can learn from the US experience in reducing healthcare-associated infections, applying the free market philosophy to healthcare, pharmaceutical supply chain management, primary care, hospice care, healthcare management, and age-based rationing
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Once we set such a limit and accept the "cultural shift" Callahan and Nuland call for, one that treats age-based rationing as morally justifiable, it is simple to show that, on average, those who are, say, 77 to 80, produce less and have greater care costs than those who are younger.
The possibility that using age-based rationing to ratchet down care will lead to troubling outcomes is far from mere speculation.
TO ARGUE AGAINST age-based rationing and the na vet of reallocation is not to suggest that the cost of Medicare--or, more precisely, of health care--should not be reduced.
Long before I met him, I was suspicious of the relatively crude position on age-based rationing
attributed to him.
(19) In further support of age-based rationing, proponents have proffered a wide gamut of benefits, including productivity, equality, natural life span, intergenerational justice and medical benefits.
Promoting age-based rationing is detrimental to the elderly in that it devalues the status of older people and caters to the values of a youth-oriented culture in which negative stereotyping based on age is prevalent.
(2.) Nancy C Jecker, 'Age-Based Rationing and Women' (1991) 266 JAMA 3012.
For the USA to impose overt age-based rationing
would only |tell aged persons that their lives are empty of meaning and worth', and leave them with |no purpose to their existence other than more of the same', thus making them even more likely to |cling desperately and selfishly to the la8t moments of life' (p.
First, it is worth noting that the share of the Medicare budget devoted to elderly people in their last year of life has been nearly constant since the inception of the program.(22) Second, even if it were possible to predict with certainty which patients would die within twelve months (something which cannot be done), and all care were to be withheld from these beneficiaries, relatively small savings would be achieved; only 22.7 billion dollars, or 4.6% of health care expenditures, would have been saved in 1987.(23) Those who advocate age-based rationing do not generally propose to withhold all medical treatment from older persons, but rather, expensive, aggressive care.
Arguments in favor of age-based rationing are founded on more than economics.
Categorical approaches such as age-based rationing
were rejected in favor of pragmatic case-oriented decisions that weigh societal cost against individual benefit.