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"Rationing" and American Health Policy

This article describes an attempt to persuade the members of a presidential commission on ethics in medicine to open a public dialogue on the rationing of medical care. The need for limits on the health care individuals receive, and the reasons why the existing delivery system fails to set such limits in an ethically acceptable manner, were outlined. It was argued that although the term "rationing" is appropriate to describe the process of setting equitable limits, the word generates so much controversy that it is avoided; this very avoidance is an obstacle to the development of sound policy. As an ethics commission, it was argued, the Commission was in a unique position to educate the public about the need for limits, and to defuse some of the controversy surrounding the word rationing. The Commissioners were not persuaded. They accepted the case for limits, in substance, but refused to use the word rationing in their report.