PuSH - Publication Server of Helmholtz Zentrum München: Kostendämpfung im Gesundheitswesen durch Rationierung

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Mielck, A. ; John, J.

Kostendämpfung im Gesundheitswesen durch Rationierung - Was spricht dafür und was dagegen?

Cost control in public health by rationing - what are the advantages and disadvantages?

Gesundheitswesen 58, 1-9 (1996)

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In Germany, the discussion on the pros and cons of rationing health care services in the statutory health insurance funds has just begun, but it will probably be of great importance in the years to come. Until now, it is mainly a political discussion with only very few researches participating. In order to enhance the matter-of-factness in this controversial debate, the experiences in the USA with rationing health care services are summarised, and in the second part a more general discussion is added on different forms and consequences of rationing. The present discussion in Germany is outlined in the third part of the paper. In our own evaluation two arguments are stressed: Firstly, the central argument that rationing of health care services is inevitable because health care costs are "exploding", has as yeb no firm empirical and theoretical basis. Secondly rationing by taking medically useful benefits from the schedule of benefits in the statutory health insurance funds is not compatible with the ethical principles governing these funds.

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