The dilemma of managing scarce health care resources

Health economists proposed maximizing additional
health gains as a criterion to set priorities and to maximize social
welfare in the microallocation of healthcare resources. This requires
that social values from health improvements are neutral in relation to
personal characteristics of people, which seems to be often contradicted
by empirical evidence. This paper addresses the social and ethical
values that can potentially conflict with economic ones in decisions
taken at the micro level of healthcare rationing. Using quantitative and
qualitative data collected from a random sample of 200 college students
we explore their (i) orientations and motivations when faced with
hypothetical scenarios involving prioritization of patients that are
distinguished only by their personal characteristics and (ii) views
concerning its involvement in decision making over which patients to
treat. Findings suggest: (i) the coexistence of fairness and economic
orientations among respondents even though utilitarianism received the
greatest support; (ii) that although respondents wish to be consulted in
matters of microallocation decisions, they do not want to assume the
role of deciding between patients