"Care is rationed in our
current system in several ways. The public policy issue
is not whether we ration care, but can we find a more
rational method of allocating resources?"—Bill
Custer, Employee Benefit Research Institute
"Most countries have found it
difficult to decide what not to cover, so they have
pushed the decisions down to local levels. True rationing
at the federal level requires a truly defined and managed
health care delivery system nationally."—Roger
S. Taylor, PacifiCare Health Systems
"The public has a lack of
trust in the leadership, and most people are unwilling to
make sacrifices because they are not convinced it is
needed and that it will help others. The public perceives
the health care system as a complicated system full of
black holes, and so they are not convinced that making
cuts in some areas will help others." —John
Immerwahr, The Public Agenda Foundation
"Because medicine is as much
art as science, rationing medical care by guidelines and
gatekeepers may be the most direct route to quality. It
may be time to worship rationing as both the route to
quality and as an economic necessity."—Dallas Salisbury, Employee Benefit
Research Institute
"A global budgeting system is
the only cost containment alternative that would involve
the type of systemwide restructuring necessary to achieve
the results that the American people expect but with the
checks and balances and opportunities for involvement
that will ensure their support."—Karen Ignagni, AFL-CIO
"Coordinated action by all
payers would impose a discipline on total spending that
no one payer could command. Providers would be forced to
reduce costs rather than shift them. "—Larry Atkins, Winthrop, Stimson,
Putnam & Roberts
"If we are going to explicitly
decide what to cover and what not to cover and how much,
who is going to get to make these decisions? If we just
turn it over to the medical profession, then the values
that will dominate those choices are those of white,
middle-aged, upper-middle class men."—Joshua Wiener, The Brookings
Institution
"The Oregon Plan eliminates
the implicit tools of health care rationing imposed by
states, businesses, and the federal government today, and
replaces them with an open, clearly defined, resource
allocation process that combines considerations of
clinical effectiveness, social value, and fiscal
responsibility. ">—Mark Gibson, formerly with the Oregon State Senate
President's Office
