Ethical Implications

CEJA Report B – I-88 Ethical Implications of Age-Based Rationing of Health Care

The American population is aging. The number of people aged 65 and over has more than doubled in the past 50 years, and current projections indicate that the number will double again within the next 50 years. The number of people aged 85 and older is increasing even more rapidly, making the older aged the fastest growing age group in the United States today. This aging of the population is a consequence of improved physician skills, advances in modern medical technology, improved sanitation, better diet and housing, social concern for the welfare of the aged, and the abundance of an affluent society that has dedicated an increasing share of its resources to health care, with an emphasis on sustenance of the poor and the aged. A commitment to provide the elderly and the poor with access to health care was embodied in the enactment of the Medicare and Medicaid programs by Congress in 1965. As the age of the population increases, however, so does the proportion of the Gross National Product devoted to the provision of health care. Since many health services that are provided to the aged are funded by the government, doubts are beginning to arise as to whether improved health and extended longevity warrant unlimited increases in health care expenditures. It has been suggested that expenditures on health care have reached or exceeded acceptable boundaries, and that further increases in the nation's health care budget should be limited. Although most would agree that in the absence of such limits health care costs will continue to rise, no agreement has been reached regarding the best means of containing such costs. One of the methods that has been proposed for limiting health care expenditures is to reduce government funding for health services, particularly as provided to the aged. This, in effect, would constitute rationing of scarce health care resources. RATIONING OF CARE One means of...