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"If there were a war tomorrow, we'd find the money": contrasting perspectives on the rationing of health care

Author

Listed:
  • Coast, Joanna
  • Donovan, Jenny
  • Litva, Andrea
  • Eyles, John
  • Morgan, Kieran
  • Shepherd, Michael
  • Tacchi, Jo

Abstract

In spite of the substantial academic effort being devoted to the subject of health care rationing, there is little clarity about the views of those working in health care who have to implement rationing nor about the views of citizens who are (potentially) affected by the rationing of care. This paper reports the findings of a study conducted using focus groups and semi-structured interviews to explore and compare beliefs about rationing among citizens and those with a role in the health service (service informants) within the context of health care provision in the UK. Citizen and service informants both identified external pressures on the resources available for health care including technological improvement, the ageing population and increasing public expectations. Citizens, however, also identified such factors as the political choice to provide insufficient funds to the health service and the wasteful use of resources that are available. The predominant view was that these latter factors were amenable to change and thus that there are alternatives to the rationing of care. Some citizens accepted that some health care rationing might be necessary. Service informants, on the other hand, were cynical about prospects of increased funding and viewed further reductions in management as untenable. For them, rationing was an inevitability to be managed. A number of these informants felt that rationing should become more explicit, suggesting that openness made rationing both more democratic and more practical. Others, however, believed that explicit rationing would have a number of uncomfortable implications. The paper concludes by suggesting that if rationing is to become more explicit, its inevitability, as perceived by those working within health care, will have to be communicated to citizens.

Suggested Citation

  • Coast, Joanna & Donovan, Jenny & Litva, Andrea & Eyles, John & Morgan, Kieran & Shepherd, Michael & Tacchi, Jo, 2002. ""If there were a war tomorrow, we'd find the money": contrasting perspectives on the rationing of health care," Social Science & Medicine, Elsevier, vol. 54(12), pages 1839-1851, June.
  • Handle: RePEc:eee:socmed:v:54:y:2002:i:12:p:1839-1851
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    Citations

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    Cited by:

    1. Russell, Jill & Greenhalgh, Trisha, 2012. "Affordability as a discursive accomplishment in a changing National Health Service," Social Science & Medicine, Elsevier, vol. 75(12), pages 2463-2471.
    2. Jane Robertson & Emily J Walkom & David A Henry, 2011. "Health Systems and Sustainability: Doctors and Consumers Differ on Threats and Solutions," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-9, April.
    3. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    4. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.

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