881:"Future growth in spending per beneficiary for Medicare and Medicaid—the federal government's major health care programs—will be the most important determinant of long-term trends in federal spending. Changing those programs in ways that reduce the growth of costs—which will be difficult, in part because of the complexity of health policy choices—is ultimately the nation's central long-term challenge in setting federal fiscal policy... total federal Medicare and Medicaid outlays will rise from 4 percent of GDP in 2007 to 12 percent in 2050 and 19 percent in 2082—which, as a share of the economy, is roughly equivalent to the total amount that the federal government spends today. The bulk of that projected increase in health care spending reflects higher costs per beneficiary rather than an increase in the number of beneficiaries associated with an aging population."
432:"Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for. But our current system of employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $ 200 billion government subsidy for health care. In the public sector, primarily Medicare, Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals."
861:"Rationing health care means getting value for the billions we are spending by setting limits on which treatments should be paid for from the public purse. If we ration we won't be writing blank checks to pharmaceutical companies for their patented drugs, nor paying for whatever procedures doctors choose to recommend. When public funds subsidize health care or provide it directly, it is crazy not to try to get value for money. The debate over health care reform in the United States should start from the premise that some form of health care rationing is both inescapable and desirable. Then we can ask, What is the best way to do it?"
616:
for similar reasons, a private health insurer refuses to pay for a particular procedure or has a price-tiered formulary for drugs – e.g., asking the insured to pay a 35 percent coinsurance rate on highly expensive biologic specialty drugs that effectively put that drug out of the patient's reach — the insurer is not rationing health care. Instead, the insurer is merely allowing "consumers" (formerly "patients") to use their discretion on how to use their own money. The insurers are said to be managing prudently and efficiently, forcing patients to trade off the benefits of health care against their other budget priorities."
866:
670:
311:
631:, would allow Medicare for the first time to cover patient-doctor consultations about end-of-life planning, including discussions about drawing up a living will or planning hospice treatment. Patients would be allowed but not required to seek out such advice on their own. The provision would limit Medicare coverage to one consultation every five years. However, as governor, Palin had supported such end of life counseling and advance directives from patients in Alaska in 2008.
752:
if quality of life cannot be improved. He also recommended for a budget to be established for government healthcare expenses by establishing spending caps and pay-as-you-go rules that require tax increases for any incremental spending. He has indicated that a combination of tax increases and spending cuts will be required. He advocated addressing those issues under the aegis of a fiscal reform commission.
322:
822:, and "just about every relevant professional and scholarly journal and newsletter." One of the major arguments against such age-based rationing is the fact that chronological age, by itself, is a poor indicator of health. Another major argument against Callahan's proposal is that it inverts the Western tradition by making death a possible good and life a possible evil.
599:
began a campaign arguing that thousands of low-income
Oregonians lacked access to even basic health services, much less access to transplants. A panel of experts was appointed, the Health Services Commission, to develop a prioritized list of treatments. The state legislators decided where on the list
480:
Dr. Gerald Grumet has chronicled how private insurers and third party payers delay and impede the utilization of medical services through creating inconvenience and confusion for both patients and physicians through complex claims review processes with layers of administrative handling that supersede
376:
is rationed on price and ability to pay. Those unable to afford a health insurance policy are unable to acquire a private plan except by employer-provided and other job-attached coverage, and insurance companies sometimes pre-screen applicants for pre-existing medical conditions. Applicants with such
888:
President Obama stated in May 2009, "But we know that our families, our economy, and our nation itself will not succeed in the 21st century if we continue to be held down by the weight of rapidly rising health care costs and a broken health care system.... Our businesses will not be able to compete;
751:
indicated that some form of rationing is inevitable and desirable considering the state of US finances and the trillions of dollars of unfunded
Medicare liabilities. He estimated that 25 to 33% of healthcare services are provided to those in the last months or year of life and advocated restrictions
615:
wrote that both public and private healthcare programs can ration and rebutted the concept that governments alone impose rationing: "Many critics of the current health reform efforts would have us believe that only governments ration things.... On the other hand, these same people believe that when,
542:
article quoted various doctors describing how
America rations healthcare. Dr. Arthur Kellermann said: "In America, we strictly ration health care. We've done it for years.... But in contrast to other wealthy countries, we don't ration medical care on the basis of need or anticipated benefit. In this
660:
to measure the cost-benefit of applying a particular medical procedure. It reflects the quality and the quantity of life added by incurring a particular medical expense. The measure has been used for over 30 years in the country's universal single-payer healthcare system and has been implemented in
607:
argued that the reform plans supported by
President Obama expand the control of government over healthcare decisions, which he referred to as a type of healthcare rationing. He expressed concern that although there is nothing in the proposed laws that would constitute rationing, the combination of
711:
Although the Mayo Clinic scores above the other two , its cost per beneficiary for
Medicare clients in the last six months of life ($ 26,330) is nearly half that at the UCLA Medical Center ($ 50,522) and significantly lower than the cost at Massachusetts General Hospital ($ 40,181)...The American
694:
Some doctors swear by one treatment, others by another. But no one really knows which is best. Rigorous research has been scant. Above all, no serious study has found that the high-technology treatments do better at keeping men healthy and alive. Most die of something else before prostate cancer
643:
how polls indicate senior citizens are increasingly resistant to healthcare reform because of concerns about cuts to the existing
Medicare program that may be required to fund it. That is creating an unusual and potent political alliance, with Republicans arguing to protect the existing Medicare
513:
Private and public insurers all have their own drug formularies through which they set coverage limitations, which may include referrals to the insurance company for a decision on whether the company will approve its share of the costs. American formularies make generalized coverage decisions by
509:
An investigation by the House
Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $ 300 million in medical claims over five
443:
in June 2009 that rationing presently an economic reality: "The choice isn't between rationing and not rationing. It's between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many
677:
Several treatment alternatives may be available for a given medical condition, with significantly different costs but no statistical difference in outcome. Such scenarios offer the opportunity to maintain or improve the quality of care while significantly reducing costs through comparative
546:
Rationing by price means accepting that there is no triage according to need. Thus, in the private sector, it is accepted that some people get expensive surgeries such as liver transplants or non-life-threatening ones such as cosmetic surgery, when others fail to get cheaper and much more
484:
President Obama noted that US healthcare was rationed based on income, type of employment, and pre-existing medical conditions, with nearly 46 million uninsured. He stated that millions of
Americans were denied coverage or face higher premiums because of pre-existing medical conditions.
514:
class, with cheaper drugs at one end of the scale and more expensive drugs with more conditions for referral and possible denial at the other end. Not all drugs may be in the formulary of every company, and consumers are advised to check the formulary before they buy insurance.
644:
program although they historically opposed that and other major entitlement programs. The CBO scoring of the proposed H.R. 3200 (America's
Affordable Health Choices Act of 2009) included $ 219 billion in savings over 10 years, some of which would come from Medicare changes.
492:
wrote, "Reform will stop 'rationing' - not increase it.... It's a myth that reform will mean a 'government takeover' of health care or lead to 'rationing.' To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies."
608:
three factors would increase pressure on the government to ration care explicitly for the elderly: an expanded federal bureaucracy, the pending insolvency of
Medicare within a decade, and the fact that 25% of Medicare costs are incurred in the final year of life.
510:
years. It also found that policyholders with breast cancer, lymphoma, and more than 1000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.
566:
Pharmaceutical manufacturers often charge much more for drugs in the United States than they charge for the same drugs in Britain, where they know that a higher price would put the drug outside the cost-effectiveness limits applied by regulators such as
803:
discusses whether healthcare should be rationed by age. He calls the elderly "a new social threat" and selfish and for age to be used as a criterion in limiting healthcare. Callahan's book has been widely discussed in the America media, including the
755:
Arizona modified its Medicaid coverage rules because of a budget problem that included denying care for expensive treatments such as organ transplants to Medicaid recipients, including those who had previously been promised funding. MSNBC's
728:
President Obama has provided more than $ 1 billion in the 2009 stimulus package to jumpstart Comparative Effectiveness Research (CER) and to finance a federal CER advisory council to implement that idea. Economist
399:
In the media and in academia, some have advocated explicit healthcare rationing to limit the cost of Medicare and Medicaid. They argue that a proper rationing mechanism would be more equitable and cost-effective.
525:
in which medical copayments are low or no nonexistent. In the United States, however, research shows that many bankruptcies have a strong medical component, even among the insured. Medical insurance before the
448:
The increases in healthcare premiums reduce worker pay. In other words, more expensive insurance premiums reduce the growth in household income, which forces tradeoffs between healthcare services and other
557:
According to a recent survey commissioned by Wolters Kluwer, the majority of physicians and nurses (79%) say the cost to the patient influences the treatment choices or recommendations the provider makes.
724:
stated: "Nearly thirty percent of Medicare's costs could be saved without negatively affecting health outcomes if spending in high- and medium-cost areas could be reduced to the level of low-cost areas."
459:
During 2007, nearly 45% of US healthcare expenses were paid for by the government. In 2009, an estimated 46 million individuals in the United States did not have health insurance coverage. In 2008,
500:
found that health spending for uninsured non-elderly Americans was only about 43% of health spending for similar, privately insured Americans. That implied rationing by price and ability to pay.
661:
several other countries to help with rationing decisions. Australia applies QALY measures to control costs and ration care and allows private supplemental insurance for those who can afford it.
252:
554:
Polling has discovered that Americans are much more likely than Europeans or Canadians to forgo necessary health care (such not seeking a prescribed medicine) on the grounds of cost.
392:(HMOs), which are common among the rest of the population, restrict access to treatment by financial and clinical access limits. Those 65 and older and a few others also qualify for
885:
In other words, all other federal spending categories (such as Social Security, defense, education, and transportation) would require borrowing to be funded, which is not feasible.
350:
829:
Professor Robert Laurence Barry called Callahan's view "medical totalitarianism." One book-length rebuttal to Callahan from half-a-dozen professors who held a conference at the
199:
88:
1222:
1133:
739:, "Comparative effectiveness could become the vehicle for deciding whether each method of treatment provides enough of an improvement in health care to justify its cost."
551:, which could save the lives of many fetuses and newborn children. Some places, like Oregon for example, explicitly ration Medicaid resources by using medical priorities.
189:
1180:"Health Care Rationing Through Inconvenience: The Third Party's Secret Weapon," Grumet, Gerald W., M.D., New England Journal of Medicine. 1989 Aug 31; 321(9): 607-611.
919:
194:
707:(CBO), the cost of healthcare per person in the US also varies significantly by geography and medical center, with little or no statistical difference in outcome:
530:
allowed annual caps or lifetime caps on coverage, and the high cost of care made it common for insured persons to suffer bankruptcy after breaching those limits.
571:. American patients, even if they are covered by Medicare or Medicaid, often cannot afford the copayments for drugs, which is rationing based on ability to pay.
980:
343:
169:
82:
113:
43:
1383:
543:
country, we mainly ration on the ability to pay. And that is especially evident when you examine the plight of the uninsured in the United States."
1789:
690:
cancer ranges from an average of $ 2,400 (watchful waiting to see if the condition deteriorates) to as high as $ 100,000 (radiation beam therapy):
76:
1809:
336:
506:
wrote that only 38% of small businesses provided health insurance for their employees during 2009, versus 61% in 1993, because of rising costs.
842:
444:
measures, it's hard to argue that we are now rationing very rationally." He wrote that there are three primary ways the US rations healthcare:
209:
1102:
600:
of prioritised procedures the line of eligibility should be drawn. In 1995 there were 745 procedures, 581 of which were eligible for funding.
1288:
914:
48:
1239:
1407:
1200:
623:
wrote against rationing by government entities, referring to what she interpreted as such an entity in current reform legislation as a "
1522:
1264:
163:
94:
1748:
1659:
889:
our families will not be able to save or spend; our budgets will remain unsustainable unless we get health care costs under control."
1804:
1593:
1444:
1723:
1480:
1140:
408:
909:
792:, was widely quoted but claimed to have been misquoted as saying that the elderly "have a duty to die and get out of the way."
107:
30:
768:
because many of those poor people who are now being denied funding will die or have health because of the political decision.
1069:
1016:
830:
1819:
712:
taxpayer is financing these large differences in costs, but we have little evidence of what benefit we receive in exchange.
489:
1468:
1420:
1211:
784:
budget on 5–6% of those eligible who then die within a year of receiving treatment. In 1984, the Democratic governor of
1189:
377:
conditions may be declined cover or pay higher premiums and/or have extra conditions imposed such as a waiting period.
69:
587:
program should cover in an attempt to develop a transparent process for prioritizing medical services. Howard died of
1706:
1677:
1647:
1621:
776:
In the US, the discussion on rationing healthcare for the elderly began to be noticed widely in 1983 when economist
1384:"Newt Gingrich, Los Angeles Times, Atlanta Journal-Constitution, August 16, 2009 "Healthcare Rationing-Real Scary""
924:
150:
132:
717:
389:
119:
1312:"A Transplant for Coby: Oregon Boy's Death Stirs Debate Over State Decision Not to Pay for High-Risk Treatments"
984:
1814:
1698:
1563:
591:, which was not funded. His mother spent the last weeks of his life trying to raise $ 100,000 to pay for a
1387:
1311:
874:
704:
404:
242:
1552:
1510:
1087:
653:
237:
232:
1004:
1790:
White House Council of Economic Advisors - The Economic Case for Healthcare Reform-Report-June 2009
1109:
781:
393:
247:
1277:
1040:
1633:
1299:
424:
287:
1529:
1639:
1354:
1243:
592:
452:
The increases also prevent smaller companies from affording health insurance for their workers.
282:
227:
22:
1778:
1338:
981:"Jim Jaffe, "Secret's Out—We Already Ration Medical Care", AARP Bulletin Today, July 30, 2009"
748:
522:
264:
144:
716:
Comparative effectiveness research has shown that significant cost reductions are possible.
657:
467:
work group to set up guidelines for rationing ventilators during a potential flu pandemic.
364:
315:
259:
138:
1576:
954:
8:
1753:
1616:. Daniel Callahan. Edition reprint. Georgetown University Press, 1995 (orig. pub. 1987).
818:
735:
527:
1448:
1164:
1487:
959:
627:" and "downright evil." Defenders of the plan indicated that the proposed legislation,
518:
326:
1702:
1673:
1643:
1617:
1358:
1258:
1012:
838:
686:
described how the cost of treating the most common form of early-stage, slow-growing
1669:
1350:
1005:
Martin A. Strosberg; Joshua M. Wiener; Brookings Institution; Robert Baker (1992).
730:
700:
373:
1469:
Washington Post-Ezra Klein-No Government Healthcare! (Except for Mine)-August 2009
1066:
900:
debating on CNN whether a single-payer system would lead to healthcare rationing.
865:
1611:
1073:
1006:
837:, edited by Robert Laurence Barry and Gerard V. Bradley, a visiting professor of
823:
812:
796:
757:
683:
639:
497:
436:
292:
1598:
893:
806:
777:
669:
596:
503:
464:
297:
1798:
1784:
826:
612:
604:
548:
385:
368:
1695:
Set No Limits: a Rebuttal to Daniel Callahan's Proposal to Limit Health Care
1362:
854:
789:
721:
419:
929:
765:
624:
620:
673:
Medicare spending per person varied significantly across states in 2006.
583:
began a programme of public consultation to decide which procedures its
1088:
NYT-Leonhardt-Healthcare Rationing Rhetoric Overlooks Reality-June 2009
835:
Set No Limits: a Rebuttal to Daniel Callahan's Proposal to Limit Health
761:
634:
460:
780:
asked "whether it is worth it" in referring to the use of 30% of the
628:
588:
1339:"Oregon's Experiment with Prioritizing Public Health Care Services"
897:
785:
687:
584:
381:
1408:
NYT-Rheinhardt-Rationing Healthcare: What Does It Mean?-July 2009
892:
Healthcare rationing remained a political topic into 2017, with
455:
The cost prevents the certain types of care from being provided.
411:
are the primary driver of government spending in the long term.
580:
428:
in July 2009 that healthcare is rationed in the United States:
1190:
Huffington Post-Nutter-Axelrod's Whitehouse E-mail-August 2009
1511:
NYT-Leonhardt-In Health Reform, A Cancer Offers and Acid Test
1067:
Peter G. Peterson on Charlie Rose-July 3 2009-About 17 min in
388:, and other federal and state eligibility regulations apply.
1594:"Gov. Lamm asserts elderly, if very ill, have 'DUTY TO DIE'"
1523:"Peter Diamond-Healthcare and Behavioral Economics-May 2008"
1134:"Centers for Medicare and Medicaid Services-Pie Charts-2007"
1665:
1445:"Office of the Governor of Alaska-Healthcare Decisions Day"
568:
920:
Public opinion on health care reform in the United States
539:
664:
561:
1564:
WSJ-Feldstein-Obamacare All About Rationing-August 2009
1212:
Washington Post-Zakaria-More Crises Needed?-August 2009
1201:
NYT-Reinhardt-Rationing Healthcare-What Does it Mean?
869:
Medicare and Medicaid Spending as a percentage of GDP
1749:"Cruz, Sanders trade jabs over healthcare rationing"
1300:
Mending Healthcare in America 2020: Consumers + Cost
1289:
Time Magazine-Ethics: Rationing Medical Care-Sept 09
384:, which is restricted by income and asset limits by
1553:
The New Yorker-Gawande-The Cost Conundrum-June 2009
1638:. Beth B. Hess, Elizabeth Warren Markson. 4th Ed.
1473:
574:
1613:Setting Limits: Medical Goals in an Aging Society
1278:NPR-Healthcare Rationing Already Exists-July 2009
1062:
1060:
801:Setting Limits: Medical Goals in an Aging Society
595:, but the boy died before treatment could begin.
1796:
1664:. Harry R. Moody, Director of Academic Affairs,
1577:"Arizona Cuts Financing for Transplant Patients"
1165:Guidelines for Epidemics: Who Gets a Ventilator?
1097:
1095:
1057:
948:
946:
944:
915:Healthcare reform debate in the United States
344:
1692:
1337:Perry, Philip; Hotze, Timothy (April 2011).
1092:
1083:
1081:
170:Health Care and Education Reconciliation Act
1034:
1032:
1030:
1028:
372:exists in various forms. Access to private
1355:10.1001/virtualmentor.2011.13.4.pfor1-1104
1336:
941:
843:University of Illinois at Urbana–Champaign
764:and the state legislatures as a real life
647:
351:
337:
1693:Barry, Robert L; Bradley, Gerard (1991).
1078:
656:" (QALY - pronounced "qualy") is used by
475:
1688:
1686:
1025:
864:
747:Former Republican Secretary of Commerce
668:
678:effectiveness research. Writing in the
579:After the death of Coby Howard in 1987
1810:Healthcare reform in the United States
1797:
1421:"Palin Weighs In On Healthcare Reform"
1418:
1263:: CS1 maint: archived copy as title (
1038:
910:Healthcare reform in the United States
1721:
1683:
1574:
952:
848:
831:University of Illinois College of Law
665:By comparative effectiveness research
562:Rationing by pharmaceutical companies
481:the autonomy of treating physicians.
396:, but it also has many restrictions.
1746:
619:During 2009, former Alaska Governor
496:A 2008 study by researchers at the
114:America's Affordable Health Choices
13:
488:In an e-mail to Obama supporters,
108:Affordable Health Care for America
70:Social Security Amendments of 1965
14:
1831:
1772:
1747:King, Robert (February 7, 2017).
1724:"Two Pillars of a New Foundation"
1661:Aging: Concepts and Controversies
1223:How Would You Ration Health Care?
1575:Lacey, Marc (December 2, 2010).
1041:"Why We Must Ration Health Care"
1008:Rationing America's medical care
925:Health care in the United States
857:argued for rationing processes:
760:and others have dubbed Governor
742:
521:is unheard of in countries with
390:Health maintenance organizations
320:
309:
1805:Healthcare in the United States
1740:
1715:
1653:
1627:
1605:
1587:
1568:
1557:
1546:
1515:
1504:
1462:
1437:
1412:
1401:
1376:
1330:
1304:
1293:
1282:
1271:
1232:
1225:Bloomberg Businessweek, citing
1216:
1205:
1194:
1183:
1174:
955:"Why We Need Healthcare Reform"
718:Office of Management and Budget
575:Rationing by government control
470:
1157:
1126:
998:
973:
833:in October 1989 was in 1991's
190:Obama administration proposals
1:
1780:Reforming American Healthcare
935:
414:
380:The poor are given access to
1722:Obama, Barack (2009-05-16).
1699:University of Illinois Press
1039:Singer, Peter (2009-07-15).
953:Obama, Barack (2009-08-15).
547:cost-effective care such as
7:
1820:Social problems in medicine
903:
875:Congressional Budget Office
705:Congressional Budget Office
533:
405:Congressional Budget Office
10:
1836:
1419:Farber, Dan (2009-08-08).
703:and research cited by the
654:quality-adjusted life year
277:Third-party payment models
89:Medicare Modernization Act
771:
233:Health insurance exchange
316:United States portal
133:American Health Care Act
32:Healthcare reform in the
21:This article is part of
1045:New York Times Magazine
877:reported in June 2008:
853:Australian philosopher
699:According to economist
648:By economic value added
517:The phenomena known as
425:New York Times Magazine
1640:Transaction Publishers
1635:Growing old in America
883:
870:
863:
714:
697:
674:
593:bone marrow transplant
476:By insurance companies
434:
407:(CBO) has argued that
327:Health care portal
283:All-payer rate setting
238:Nationalized insurance
200:Reform advocacy groups
1728:RealClearPolitics.com
1343:AMA Journal of Ethics
879:
868:
859:
749:Peter George Peterson
709:
692:
672:
523:universal health care
430:
253:Canadian vs. American
145:Healthy Americans Act
1815:Rationing by country
1481:"CBO Report-July 14"
611:Princeton Professor
365:Healthcare rationing
139:Medicare for All Act
1754:Washington Examiner
819:Wall Street Journal
736:Wall Street Journal
658:Australian Medicare
528:Affordable Care Act
164:Affordable Care Act
151:Health Security Act
1581:The New York Times
1318:. 28 December 1987
1169:The New York Times
1072:2012-03-19 at the
960:The New York Times
871:
849:Arguments in favor
695:becomes a problem.
675:
652:A concept called "
519:medical bankruptcy
210:Insurance coverage
120:Baucus Health Bill
1602:. March 29, 1984.
1316:Los Angeles Times
1018:978-0-8157-8197-4
839:religious studies
795:Medical ethicist
637:described in the
409:health care costs
361:
360:
141:(2021, H.R. 1976)
35:
1827:
1767:
1766:
1764:
1762:
1744:
1738:
1737:
1735:
1734:
1719:
1713:
1712:
1690:
1681:
1670:Pine Forge Press
1657:
1651:
1631:
1625:
1609:
1603:
1591:
1585:
1584:
1572:
1566:
1561:
1555:
1550:
1544:
1543:
1541:
1540:
1534:
1528:. Archived from
1527:
1519:
1513:
1508:
1502:
1501:
1499:
1498:
1492:
1486:. Archived from
1485:
1477:
1471:
1466:
1460:
1459:
1457:
1456:
1447:. Archived from
1441:
1435:
1434:
1432:
1431:
1416:
1410:
1405:
1399:
1398:
1396:
1395:
1386:. Archived from
1380:
1374:
1373:
1371:
1369:
1334:
1328:
1327:
1325:
1323:
1308:
1302:
1297:
1291:
1286:
1280:
1275:
1269:
1268:
1262:
1254:
1252:
1251:
1242:. Archived from
1236:
1230:
1220:
1214:
1209:
1203:
1198:
1192:
1187:
1181:
1178:
1172:
1171:, March 25, 2008
1161:
1155:
1154:
1152:
1151:
1145:
1139:. Archived from
1138:
1130:
1124:
1123:
1121:
1120:
1114:
1108:. Archived from
1107:
1099:
1090:
1085:
1076:
1064:
1055:
1054:
1052:
1051:
1036:
1023:
1022:
1002:
996:
995:
993:
992:
983:. Archived from
977:
971:
970:
968:
967:
950:
731:Martin Feldstein
701:Peter A. Diamond
374:health insurance
353:
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797:Daniel Callahan
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684:David Leonhardt
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1759:. Retrieved
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1537:. Retrieved
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1449:the original
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1392:. Retrieved
1388:the original
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1366:. Retrieved
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1244:the original
1234:
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985:the original
975:
964:. Retrieved
958:
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855:Peter Singer
852:
834:
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811:
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790:Richard Lamm
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722:Peter Orszag
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538:A July 2009
537:
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471:Methods used
458:
449:consumption.
440:
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423:
420:Peter Singer
418:
402:
398:
379:
363:
362:
248:Single-payer
204:
147:(2007, 2009)
15:
1425:cbsnews.com
930:Death panel
766:death panel
625:death panel
621:Sarah Palin
603:Republican
228:Free market
173:(H.R. 4872)
166:(H.R. 3590)
153:(H.R. 3600)
116:(H.R. 3200)
110:(H.R. 3962)
59:Legislation
1799:Categories
1733:2017-12-17
1668:. 5th Ed.
1539:2009-08-25
1497:2009-08-30
1455:2009-08-17
1430:2017-12-17
1394:2009-09-29
1250:2011-01-03
1150:2009-08-17
1119:2009-08-18
1050:2017-12-17
991:2009-09-29
966:2017-12-17
936:References
762:Jan Brewer
635:Ezra Klein
461:Tia Powell
415:Background
288:Capitation
102:Superseded
1650:. p. 329.
629:H.R. 3200
589:leukaemia
265:Universal
205:Rationing
122:(S. 1796)
64:Preceding
1680:. p.301.
1672:, 2006.
1642:, 1991.
1363:23131332
1259:cite web
1227:LA Times
1070:Archived
904:See also
898:Ted Cruz
799:'s 1987
786:Colorado
782:Medicare
688:prostate
585:Medicaid
534:By price
394:Medicare
382:Medicaid
260:Two-tier
127:Proposed
23:a series
1229:article
841:at the
367:in the
222:Systems
184:Reforms
44:History
1705:
1676:
1646:
1620:
1368:19 May
1361:
1322:19 May
1015:
816:, the
810:, the
772:By age
581:Oregon
463:led a
135:(2017)
97:(2005)
91:(2003)
85:(1996)
79:(1986)
77:EMTALA
49:Debate
1783:from
1533:(PDF)
1526:(PDF)
1491:(PDF)
1484:(PDF)
1144:(PDF)
1137:(PDF)
1113:(PDF)
1106:(PDF)
95:PSQIA
83:HIPAA
1763:2018
1703:ISBN
1674:ISBN
1666:AARP
1644:ISBN
1618:ISBN
1370:2015
1359:PMID
1324:2015
1265:link
1013:ISBN
896:and
873:The
569:NICE
403:The
1351:doi
540:NPR
1801::
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