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PNHP RESOURCES

Rationing or waiting?

Kip Sullivan, noted author on health policy:

We should undertake a campaign to stamp out the use of "rationing" to mean "waiting" where no harm is caused by waiting. "Rationing" in common parlance means "denial of a necessary service," as in, "Cuba is
rationing electricity by shutting off power to whole neighborhoods for hours at a time." Waiting nine months for a bone marrow transplant (US) or ten (Canada) is not rationing in the absence of evidence that this delay is harmful (George Silberman et al., "Availability and appropriateness of allogeneic bone marrow transplantations for chronic myeloid leukemia in ten countries," New England Journal of Medicine 1994:331:1063-1067).

Those who use rationing to mean waiting for care put harmless waiting in the same category with denial. There oughta be a law against it.

Comment: Ida Hellander, commenting on the same study, notes that "the data show that some countries that have been characterized in the public debate as much more restrictive in the provision of sophisticated health care treatments actually had levels of transplantation that were equivalent to, if not greater than, those of the United States."