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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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The Cutoff Problem, or Where and How to Draw the Line

The Cutoff Problem, or Where and How to Draw the Line

(p.93) 4 The Cutoff Problem, or Where and How to Draw the Line
Rationing Is Not a Four-Letter Word

Philip M. Rosoff

The MIT Press

This chapter introduces various approaches for deciding what healthcare interventions it is reasonable to ration and how this might be accomplished. The discussion considers other approaches that have been suggested by other authors, including rationing on the basis of age and discards them as both unfair and unlikely to be acceptable to the large majority of Americans. There is also an introduction to the problem of boundary issues for variables that are continuous (such as age) when drawing lines for what interventions should and should not be available. Finally, it is concluded that the most reasonable method would be to exclude interventions that offer only futile or marginal benefits. Case examples are provided throughout.

Keywords:   Marginally beneficial, Rationing, Cutoffs, Futility

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