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Cost Containment in Infection Control: Ethical Problems in Rationing Medical Care

Published online by Cambridge University Press:  02 January 2015

Ruth Macklin
Ruth Macklin*
Affiliation:
Albert Einstein College of Medicine, Bronx, New York
*
Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461
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Extract

The era of cost containment is upon us. Bureaucrats and regulators, politicians and insurance administrators have begun to devise schemes for reducing the costs of hospital care and medical services in a country justly proud of the quality of its health care. The term “cost containment” has a neutral ring to it, a tone deliberately chosen by policy makers to soften the impact of its effects. The concept has an aura of virtue, conjuring an image of overflowing expenditures that must be put back into the container. But let us recognize the harsh reality that cost containment is simply another term for rationing, a notion that has somewhat unsavory connotations.

The need to embark on rationing arises when a crisis of available goods or services is imminent. We are told that too much money is being spent today on health care in the US. Since spending too much on anything is considered wasteful, and since wastefulness is at least an inefficient, if not an unethical way to treat resources, the conclusion seems inescapable that there is a moral imperative to cut costs in the health care sector. To be sure, the goals of eliminating waste and reducing excessive costs should be pursued by hospitals and physicians alike. But let us not hide behind these noble goals and accept uncritically the idea that to increase efficiency in delivering health care, it is necessary to embark on rationing schemes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 9 , September 1985 , pp. 375 - 380
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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References

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