Talk:Health care rationing

Should this article talk about the reality of rationing? I mean here that of course since there is effectively unlimited potential to spend on healthcare and only finite resources available we always have to ration it somehow. I know a little bit about the UK situation, where for the most part such rationing is implemented locally (by clinicians), but the broad decisions are taken nationally (by NICE) and occasionally interfered with by politicians. Ultimately of course the NHS has a budget, modest local overspends might be tolerated, but if you go seriously over budget people from the Ministry are going to start closing hospitals to make the numbers add up. What's "on mission" here and what isn't? Is there somewhere else on the Wiki that we should explain some of these things? 81.2.89.113 (talk) 14:22, 3 February 2013 (UTC)

Insurance company rationing
Healthcare actuary here. Insurance companies do not "ration" care in the US. They might deny coverage for experimental treatments (i.e., unproven and in many cases outright unscientific procedures), which is different, but if it's covered by the plan it's covered by the plan regardless of cost. Even if the person costs over a million dollars per month, which is part of why premiums have been increasing by double digits each year. The extremely high cost claimants are essentially a non-issue anyway for the insurance company, as that's the re-insurers' problem, at least until the reinsurer then needs to turn around and raise rates on the insurance company, who passes it on to a combination of the members and the taxpayers, but mostly the taxpayers due to the Advanced Premium Tax Credit and all. The real nightmare for the insurance companies are having a lot of high cost claimants that don't reach the threshhold for reinsurance rather than a few extremely high cost claims.

In the prison systems, there is indeed rationing of care, and it can lead to some really bizarre ethical issues where the sexual offender gets priority treatment for STDs and HIV because otherwise they'd infect the other inmates, but that's what you get for underfunding prisons. CoryUsar (talk) 00:53, 1 March 2019 (UTC)