Abstract
Introduction
Is health care the only business where companies and institutions are actively
turning away customers rather than fi nding innovative ways to serve them?
Health care reform that is aimed at managing demand-as opposed to rationing
supply-is a much more compelling answer to today' s seemingly intractable
problem of fi nding the necessary resources to meet the growing demands of
health care.
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Nothing about health care rationing is straightforward, transparent, or even
rational. How is health care rationing perceived by various stakeholders? What
problems does it present? The percentage of the population that is aged 65+
ranges from 12% to 19% and will grow even larger. How will this inverted
population pyramid affect health care economics? What demands will this
constituency make? Expectations for health care delivery have changed. How
does this relate to the rise of "lifestyle drugs," and how does that trend in
health care perpetuate the problem? How do changing expectations clash with
the original design of health care funding systems? What impact do technology
improvements have? The concept of managing demand might appear to limit
commercial opportunities for pharmaceutical companies. Is that the case? Or
are there remaining, or new, areas of opportunities for these stakeholders?
Scope
- The critical need for health care reform and why efforts to date have
failed: We explain how four trends have widened the gap between the demand for
health care and the ability to fund and provide it, and we plumb the
inadequacies of health care reform efforts to date (e.g., effi ciency
improvements, limited coverage, covert rationing, distributed justice).
- Health care economics 101: Understand the overarching trends at work that
feed the demand and supply problem.
- Modifying health care demand: We discuss eight opportunities to effect
demand-side change.
- Expert Commentary: A Decision Resources analyst explains how results of a
survey point to the impact of rationing on the quality of health care.
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