The allocation of scarce medical interventions represents an economic and

The allocation of scarce medical interventions represents an economic and ethical challenge. Allocating beds in intensive care units, organs to transplant, and vaccines during flu epidemics are just a few examples of difficult decisions. Morally relevant ethical principles have been studied and four methods have been examined including • “treating people equally” by use of a “lottery” or a “first-come, first-served” basis; • “favouring the worst-off” such as the sickest or youngest; • “maximizing total benefits” by saving lives or life-years; and • “promoting and rewarding social usefulness” or values such as prioritizing vaccines for healthcare workers or health interventions for those who served in the military (Persad, Wertheimer & Emanuel 2009). Resource allocation in health care demands that we answer the following questions: • What types of services are offered? • What are the criteria to determine who gets the services? • What financial and ethical issues are involved in making these health care allocation decisions? • Who applies the criteria? • What is the process? • Can they be applied consistently? • How does oversight occur? The economic problem of scarcity in Medicaid funding must be addressed in the following scenario. You are on the state committee to allocate funding for Medicaid programs and payments. Rank the following priorities for spending using the information in the table given (1 should be the highest priority and 13 the lowest priority). The demand data are hypothetical and the cost data are approximate. The total state Medicaid budget is $40 million. Before ranking the services, discuss the questions above concerning resource allocation. Examine the four methods of ethical allocation as they apply to this situation. In conclusion, consensus on criteria for allocating health care resources is difficult because Americans cannot say no to health care (Mariner, 1995). This case illustrates the difficulty in making these tough decisions. Unless Americans face an actual serious scarcity of health care resources, allocation will be an unpopular method to help control rising health care expenditures. Intervention Demand of Patient Number cost $ per intervention Rational Rank Hip replacement 100 75,00 Counseling session for mental illness 5,000 75 Bunion removal 500 500 physical therapy session for developmentally disabled 5,000 75 Hernia 500 1,750 Open Heart surgery 100 150,000 Visit for smoking cessation program 10,000 75 Kidney transplant 100 50,000 Cataract treatment 500 3,000 Surgery for varicose veins 100 1,500 Diabetes prevention counseling visit 25,000 50 Nutrition counseling 10,000 50 Pregnancy check 50,000 50 For discussion Prioritize the 13 interventions in Case 40 in the Prioritization and Allocation of Funding Chart and list them in order. Below each intervention justify why you rated each intervention in the order you selected.

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