In any system that limits the availability of certain goods, some will gain access to them and others will not. It is possible to conceive of the latter as losers in some way. This chapter discusses various ways to think about people who will not get the healthcare interventions they think they should have, because of rationing. If the system is functionally and procedurally fair (as formulated in Chapter 3), then people who have been denied an intervention cannot be thought of having lost something unfairly. This chapter describes “real” losers as those individuals who have lost access to healthcare unfairly, as by a misapplication of the rules or by open or covert bias. The question that remains is whether these losers are owed any redress or recompense for their loss. The conclusion is that it would be cumbersome to do so, except to use these cases to make the rules fairer.
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