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The political economy of rationing health care in England and the US: the ‘accidental logics’ of political settlements

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  • Bevan, Gwyn
  • Brown, Lawrence D.

Abstract

This article considers how the 'accidental logics' of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing, which we define to be the denial of health care that is beneficial but is deemed to be too costly. This article argues that rationing is designed into the English NHS and designed out of US Medicare; and compares rationing for the elderly in the United States and in England for acute care, care at the end of life, and chronic care.

Suggested Citation

  • Bevan, Gwyn & Brown, Lawrence D., 2014. "The political economy of rationing health care in England and the US: the ‘accidental logics’ of political settlements," LSE Research Online Documents on Economics 57129, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:57129
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    File URL: http://eprints.lse.ac.uk/57129/
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    References listed on IDEAS

    as
    1. Brown, Lawrence D., 2012. "Stealing on insensibly: end of life politics in the United States," Health Economics, Policy and Law, Cambridge University Press, vol. 7(4), pages 467-483, October.
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    3. Barer, Morris L. & Evans, Robert G. & Hertzman, Clyde & Lomas, Jonathan, 1987. "Aging and health care utilization: New evidence on old fallacies," Social Science & Medicine, Elsevier, vol. 24(10), pages 851-862, January.
    4. Evans, Robert G., 1987. "Public health insurance: the collective purchase of individual care," Health Policy, Elsevier, vol. 7(2), pages 115-134, April.
    5. Karl Claxton & Steve Martin & Marta Soares & Nigel Rice & Eldon Spackman & Sebastian Hinde & Nancy Devlin & Peter C Smith & Mark Sculpher, 2013. "Methods for the estimation of the NICE cost effectiveness threshold," Working Papers 081cherp, Centre for Health Economics, University of York.
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    • N0 - Economic History - - General

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