Question

What are the arguments for and against rationing health care on the basis of age? As the number of Medicare enrollees is projected to increase dramatically in the years ahead, what changes to Medicare would you propose in order to contain costs? Explain.

Answer 1

• Those who oppose age-based healthcare rationing believe that resource allocation based on age rather than need is agist: a prejudice based on presumptions that the elderly benefit little from healthcare interventions, are not in paid employment, are disproportionate consumers of benefits and whose life expectancy is inevitably short.
• Those conforming to this school of thought agree that medical care that extends life devoid of human qualities should be rationed, it is suggested that this principle should apply to people of all ages, not just the elderly.
• As age alone is a poor marker of disability, decision making in medicine should be based on the individual's premorbid functional capacity, general health, potential benefit and quality of life.
• Most healthcare expenditure on the elderly is for routine care, which few could argue should be denied on the basis of age.
• In contrast, because of their longer life expectancies, younger permanently disabled people may end up using far more healthcare resources than an older disabled person. Therefore, it is important to consider the individual before deciding to deny healthcare on the basis of age alone.
• Healthcare reforms that encourage functional independence and community based care of the elderly are more likely to lead to cost savings than simple rationing according to age.
• Treatment options previously thought futile in the elderly, particularly surgical interventions and drug therapy for cardiovascular disease, have been shown to be effective in terms of improved health and cost benefit. Thus, discrimination on the basis of age (agism) is not only ethically unacceptable in a society embracing principles of justice and equity, but also unsupportable on scientific and/or economic analysis.
• Medicare should be allowed greater negotiating power.Medicare is prohibited by law from negotiating lower prices for drugs and has to pay sticker price, or something very close. Again, this is billions of dollars every year that raises costs across the board.
• Subsidizing medical school education and expand the number of residency slots across the country.
• The only way for the US to actually achieve a reduction in healthcare costs is to move from a private insurance company-based system, to a single payer healthcare system.
• Also,prescribing more generic drugs with the same effects rather than special high-cost medicine and also restrict free drugs so people stop buying antibiotics whenever they feel they are getting fever. Hence the overall immunity of the population will rise and people will be more resistant to average bacteria/viruses.