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Rationing Is Not a Four-Letter WordSetting Limits on Healthcare$
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Philip M. Rosoff

Print publication date: 2014

Print ISBN-13: 9780262027496

Published to MIT Press Scholarship Online: January 2015

DOI: 10.7551/mitpress/9780262027496.001.0001

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Existing Rationing Systems: Organ Transplantation, Scarce Drugs, and Oregon

Existing Rationing Systems: Organ Transplantation, Scarce Drugs, and Oregon

(p.35) 2 Existing Rationing Systems: Organ Transplantation, Scarce Drugs, and Oregon
Rationing Is Not a Four-Letter Word

Philip M. Rosoff

The MIT Press

This chapter initiates the main argument by describing in detail three systems of open, formal rationing in American healthcare: solid organ transplantation, scarce drug allocation, and the Oregon Health Plan (created in the late 1980s to improve and expand medical care for poor residents of the state). While there are clear differences between the three approaches, as well as dissimilar goals and aims, they bear striking similarities in several crucial domains. Remarkably, all three systems have been accepted not only by the people immediately affected (patients), but also by the public in general, indicating that rationing per se may not be as intolerable as suspected.

Keywords:   Rationing, Organ transplant, Drug scarcity, Oregon Health Plan

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