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Healthcare rationing in the United States exists in various forms. Access to private health insurance is rationed based on price and ability to pay. Those not able to afford a health insurance policy are unable to acquire one, and sometimes insurance companies pre-screen applicants for pre-existing medical conditions and either decline to cover the applicant or apply additional price and medical coverage conditions.〔(NYT-President Obama-Why We Need Healthcare Reform-August 15 2009 )〕〔(Jim Jaffe, "Secret’s Out—We Already Ration Medical Care", AARP Bulletin Today, July 30, 2009 )〕〔(Steven Ertelt, "Obama Health Secretary Sebelius Claims Govt. Health Care Won't Include Rationing", June 29, 2009 ) 〕 Access to state Medicaid programs is restricted by income and asset limits via a means-test, and to other federal and state eligibility regulations. Health maintenance organizations (HMOs) that commonly cover the bulk of the population, restrict access to treatment via financial and clinical access limits.〔 〕 The Patient Protection and Affordable Care Act passed in March 2010 will prohibit insurers from limiting coverage to people with preexisting conditions beginning in 2014, which will alleviate this type of rationing. Some in the media and academia have advocated rationing of care to limit the overall costs in the U.S. Medicare and Medicaid programs, arguing that a proper rationing mechanism is more equitable and cost-effective.〔 (NYT-Singer-Why We Must Ration Healthcare-July 15, 2009 )〕〔(Peter G. Peterson on Charlie Rose-July 3 2009-About 17 min in )〕〔(NYT-Leonhardt-Healthcare Rationing Rhetoric Overlooks Reality-June 2009 )〕 The Congressional Budget Office (CBO) has argued that healthcare costs are the primary driver of government spending over the long-term.〔(CBO Testimony )〕 ==Background== Peter Singer wrote for the ''New York Times Magazine'' in July 2009 that healthcare is rationed in the United States: David Leonhardt wrote in the ''New York Times'' in June 2009, that rationing presently an economic reality: "The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it’s hard to argue that we are now rationing very rationally." He wrote that there are three primary ways the U.S. rations healthcare:〔 #Increases in healthcare premiums reduce worker pay. In other words, more expensive insurance premiums are reducing the growth in household income, which forces tradeoffs between healthcare services and other consumption. #High premiums mean smaller companies cannot afford health insurance for their workers. #Failure to provide certain types of care. During 2007, nearly 45% of U.S. healthcare expenses were paid for by the government.〔(Centers for Medicare and Medicaid Services-Pie Charts-2007 )〕 During 2009, an estimated 46 million individuals in the United States did not have health insurance coverage. Further, an additional 14,000 or more people lose coverage every day, due to job losses or other factors.〔 During the 1940s, a limited supply of iron lungs for polio victims forced physicians to ration these machines. Dialysis machines for patients in kidney failure were rationed between 1962 and 1967. More recently, Tia Powell led a New York State Workgroup that set up guidelines for rationing ventilators during a flu pandemic.〔(Guidelines )〕〔Cornelia Dean, (Guidelines for Epidemics: Who Gets a Ventilator? ), ''The New York Times'', March 25, 2008〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Healthcare rationing in the United States」の詳細全文を読む スポンサード リンク
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