Rationing of medical care from an economic perspective

The rationing of medical care is inevitable. The economic term "rationing" describes in a value-neutral manner that goods and services have to he with hold if financial means are limited. A changing demographic structure of society, rising expectations of patient s as well as relatives and medical-technological progress are the main reas ons for the rising rationing pressure and these developments can, if at all , be influenced only to a minor degree. Rationalization, i.e. to increase efficiency is a prerequisite before any r ationing should be initiated and it often combines cost-savings with improv ed patient care. Rationalisation, however, cannot render rationing unnecess ary. Rational should take place in an explicit manner, with open discussions and comprehensible modes of discussion. One has to ask. a) which ideas about j ustice prevail in a society, b) which philosophical theory could provide a widely accepted and coherent basis for a rationing calculus and c) how a th eoretical model can be transformed into application social politics and dec ision modes.