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Am J Bioeth. 2011 Jul;11(7):7-14. doi: 10.1080/15265161.2011.577511.

Rationing just medical care.

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  • 1Family and Preventive Medicine and Medicine, University of California-San Diego School of Medicine, La Jolla, CA 92093, USA.


U.S. politicians and policymakers have been preoccupied with how to pay for health care. Hardly any thought has been given to what should be paid for--as though health care is a commodity that needs no examination--or what health outcomes should receive priority in a just society, i.e., rationing. I present a rationing proposal, consistent with U.S. culture and traditions, that deals not with "health care," the terminology used in the current debate, but with the more modest and limited topic of medical care. Integral to this rationing proposal--which allows scope to individual choice and at the same time recognizes the interdependence of the individual and society--is a definition of a "decent minimum," the basic package of medical treatments everyone should have access to in a just society. I apply it to a specific example, diabetes mellitus, and track it through a person's life span.

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