Political Accountability in Health Care Rationing: In Search of a New Jerusalem

Abstract

In June 1989 the Oregon Legislative Assembly approved a package of bills that will ration health care for thousands of the state's poor and uninsured population. In doing so it started a national debate that shows no signs of abating. Over the last two years, health care providers, talk show hosts, scholars, print and media journalists, social advocacy groups, and public policymakers around the nation have ruminated on the necessity, practicality, and morality of health care rationing.1 Clearly the prospect of withholding health services that might reduce or eliminate human suffering or save human life is an anathema to some very fundamental American values. In addition, there is a sense of moral and political discomfort over the fact that rationing, as it is now proposed in Oregon and contemplated elsewhere, would primarily apply to the working and non-working poor and not to the middle and upper-classes.