Healthcare rationing problems have escalated, being facilitated by different factors, most of which can be resolved through effective planning and the building of new policies toward improving healthcare services. Based on the rationing causes and challenges to the patients and their loved ones, it is the role of the healthcare organizations and government to consider the main subjects that lead to rationing. Different spectrum strategies are designed to ensure that all patients are treated equally. Although there are other instances in which rationing must be the only option, numerous factors lead to rationing that can be resolved through alternative provisions to rationed services. Rationing in healthcare impacts patients and their loved families when they fail to access services in healthcare organizations, which emphasizes the necessity of involving various approaches to solve the problem.
Healthcare rationing became the most serious and debated concern in many countries, especially during the COVID-19 pandemic. For instance, in Italy, the pressure on the healthcare system was dramatically high, which raised the question of “if and how” to determine rationing criteria (Lund & Ayers, 2020, p. S210). On the contrary, the U. S. government attempted to balance the situation with rationing guidelines, though they only raised ethical challenges (Lund & Ayers, 2020). For instance, there was a problem of postponement of surgeries “to free up space for coronavirus patients” (Fink, 2020). Nevertheless, the main aspect of the issue is that demand for healthcare services will always exceed the availability of resources, which forces both medical staff and decision-makers to set priorities (Hauge et al., 2022). Given this, it can turn out to be difficult to distribute limited resources to the highest number of people.
However, one cannot underestimate the role of institutions, especially those protecting the rights of vulnerable communities. For example, the Office for Civil Rights managed to reach relative success with its bulletin underlining that the disability civil rights law “must be adhered to in pandemic planning” (Lund & Ayers, 2020, p. S210). Nevertheless, the perception of disabled people’s lives as less worthy still prevails in society. On the other hand, the experience of Portugal shows that mass media can represent an opportunity for the public to change the situation (Pinho & Costa, 2020). One of the cases concerned the treatment of hepatitis C when Portuguese media forced “political actors to respond to public preferences” (Pinho & Costa, 2020, p. 6). As a result, the necessary medications became available for those who needed them.
Nevertheless, healthcare professionals also need to seek new possible ways to mitigate ethical problems and discrimination. In the rationing context, hospitals may offer “black Americans less treatment than white Americans” (Fink, 2020). However, in New Jersey, the Directive has been implemented that requires healthcare staff to rely on objective findings about a patient (Schmidt et al., 2021). The Sequential Organ Failure Assessment helps to perform an evaluation of “eight separate measures” that determine the likelihood of a patient’s death (Schmidt et al., 2021, p. 127). Thus, the development of objective tools can minimize discrimination because they assess the severity of the condition but not the skin color.
Finally, healthcare rationing remains a highly problematic issue because it raises a range of ethical concerns. Although rationing aims to distribute vital resources among the highest possible number of patients, it leaves the gaps in the accessibility of treatment for vulnerable groups unaddressed. However, it is possible to influence the problem through different channels, such as the involvement of right-protecting institutions and mass media and the implementation of effective medical evaluation tools.
Reference
Fink, S. (2020). The Hardest questions doctors may face: Who will be saved? Who won’t?The New York Times. Web.
Lund, E. M., & Ayers, K. B. (2020). Raising awareness of disabled lives and health care rationing during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S210–S211. Web.
Hauge, A. M., Otto, E. I., & Wadmann, S. (2022). The sociology of rationing: towards increased interdisciplinary dialogue — a critical interpretive literature review. Sociology of Health & Illness, 44(8), pp. 1287-1304. Web.
Pinho, M., & Costa, E.D. (2020). Can mass media be an obstacle to rationing decisions? A case report from Portugal. International Journal of Health Governance, 25(1), pp. 3-11. Web.
Schmidt, H., Roberts, D. E., & Eneanya, N. D. (2021). Rationing, racism, and justice: Advancing the debate around “colorblind” COVID-19 ventilator allocation. Journal of Medical Ethics, 48(2), pp. 126-130. Web.