post by Paul Kelleher
I am preparing syllabi for two upcoming courses in which rationing and, specifically, physician rationing will be discussed. I won't rehearse it here (since you should go read it), but this post by Aaron Carroll will be required reading in each class.
In perusing my files for other readings, I came across an old paper by Charles Fried, a long-time Harvard Law School professor and Reagan's Solicit0r General. Fried's paper closes with this memorable quote that echoes Carroll's sentiments:
The doctor in his dealings with his patient must not act like a bureaucrat, policy maker, or legislator. But policy makers, voters, and legislators must think in different terms. It is monstrous if an individual doctor thinks like a budget officer when he cares for his patient in need; but it is chaotic and incoherent if budget officers and voters making general policy think like doctors at the bedside.
Much more on these themes in due course.
ADDENDUM: I should note that Carroll does not suggest that it would be "monstrous" if individual doctors engaged in rationing (though he may believe that; I don't know). His agreement with Fried is that someone other than doctors should be tasked with saying "No."
Comments