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Healthcare rationing is coming -- with a vengeance. What's Your Life Worth? previews tomorrow's healthcare system, showing what it'll feel like to be at the mercy of a system that might choose not to cure you. Right now, experts are calculating which diseases are worth curing, which treatments are worth paying for, and which aren't. This book tells you who they are, what they're up to, what they think you're worth -- and what to do about it.
(NOTE: Each chapter ends with Endnotes.)
1. Is It NICE to Ration?
Putting a Price on Your Life. The Pressure to Ration. Cutting to the Chase. Rationing Drugs Down Under. The National Institute for Clinical Excellence (NICE). The Beta-Interferon Controversy. Medicine versus Economics.
Rationing and Toy Shopping. Are We Wasting Money on Health Care? Moral Hazard. The RAND Study. Demand Inducement. Bad Buys in Health Care. The Wennberg Variations. Defending Rationing.
Rationing in Germany. Controlling Drug Costs in Germany. If It Looks Like Rationing. Rationing in Canada. The Consequences of Waiting Lists. The Future of Rationing in Canada. Rationing in England. Rationing Elsewhere in the World.
Rationing Through the Market Mechanism: The Uninsured in the United States. Attempts to Provide Universal Coverage. Rationing Among Insured Americans. Government-Sponsored Rationing in the United States. A Brief History of Managed Care. MCO Strategies for Containing Costs. Whither Rationing in America? Enough Is Enough.
Some Background on CEA. Is It Valid to Use CEA for Health Care? Doing CEA/CBA. Measuring Costs. Discounting. Is CEA/CBA Research Valid? CBA/CEA in Practice.
Using Rating Scales to Measure Health States. Working with QALYs. Putting QALYs into Practice. All QALYs Are Equal. Measuring QALYs. How Do Your QALY Scores Measure Up? The Quality of Well-Being (QWB) Scale. Concerns about QALYs. Discrimination and QALYs. Limitations of QALY Surveys. Summing Up CEA/CBA Methods. What about the PSA Test?
Rationing in Oregon. The Story of Coby Howard. Toward a Rational Rationing Plan. The Creation of the Oregon Health Plan. The Oregon Plan and HMOs. Creating the List. The New List. More Protests. The Performance of the Rationing Plan. Oregon Ten Years Later. Where Do We Draw the Line?
Willingness to Pay, Human Capital, and Intrinsic Value. Pricing Life in the Real World. The Cost-of-Illness (COI) Approach. Using Surveys to Put a Price. on Good Health. Some WTP Measures. Willingness to Pay for Life. How Useful Are WTP Measures? Statistical versus Identified Lives. The Economic Approach to Valuing Statistical Lives. Other Evidence on the Value of Life. What Is Your Life Worth? Value of a QALY. Responding to Mr. Mortimer. The Bottom Line.
The Health Care Budget “Crisis”. The Drain on the U.S. Economy. Targeting Technology. The Fallacy of Cost Containment. The Steady Drumbeat of Rational Rationing. Can Patients Be Rational? Who Should Ration? Rational Rationing in the Public Sector. Rational Rationing and Managed Care. The Real Obstacles. Rational Rationing in the 21st Century.