The political economy of rationing health care in England and the US: the 'accidental logics' of political settlements. Issue 3 (23rd April 2014)

• Record Type: Journal Article
• Authors: Bevan, Gwyn; Brown, Lawrence D.
• Is Part Of: Health economics, policy and law. Volume 9:Issue 3(2014)
• Page Start: 273
• Page End: 294
• Publication Date: 2014-04-23
• Subjects: Medical economics -- Periodicals; Medical policy -- Periodicals; Medical laws and legislation -- Periodicals; 362.1
• DOI: 10.1017/S1744133114000127
• Languages: English
• ISSNs: 1744-1331

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <p>This article considers how the 'accidental logics' of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing, which we define to be the denial of health care that is beneficial but is deemed to be too costly. This article argues that rationing is designed into the English NHS and designed out of US Medicare; and compares rationing for the elderly in the United States and in England for acute care, care at the end of life, and chronic care.</p> </abstract>