Prioritizing Resource Allocation between Children and the Elderly
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This essay presents a perspective of prioritizing resource allocation between children and the elderly. The essay also discusses the ethical issues that may arise in the decision making of resource allocation for the care of the elderly and the care of children.
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Running head: HEALTH ECONOMICS
HEALTH ECONOMICS
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HEALTH ECONOMICS
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1HEALTH ECONOMICS
Introduction:
In the medical system, it is not surprising that there has been much discussion regarding
the allocation of resources and choosing the deserving person for the limited resources (1). The
resource allocation is a much-discussed topic that concerns the right distribution of the resources
driven by high cost and pressure from the state. Medical supplies have been witnessing a steep
rise in price for it is present in a limited amount in society (2). Many researchers have proposed
various solutions based on multiple aspects, however, the topic is debatable, and experts view it
from different perspectives. Also, the issue is not only questionable but also about setting the
priority. On what basis patients should be prioritized to become more eligible to receive medical
resources than the other patient (3). Although healthcare providers demands for more resources
as per the judiciary one of the key factors of health system performance is the decision of
determining appropriate priority. Under the broad aspect of resource distribution, one of the
branch topics is prioritizing available resources for the care of children versus care for elderly.
This essay presents a perspective of prioritizing resource allocation between children and the
elderly. The essay also discusses the ethical issues that may arise in the decision making of
resource allocation for the care of the elderly and the care of children.
Priority setting and resource allocation:
All the health organizations across the world are required to set priorities to allocate
resources among the patients within the limited funding available to them. The health
organizations have the responsibility to meet the health needs of the population as best as
possible (4). However, due to limited resources, it is often not possible to provide the pre-defined
Introduction:
In the medical system, it is not surprising that there has been much discussion regarding
the allocation of resources and choosing the deserving person for the limited resources (1). The
resource allocation is a much-discussed topic that concerns the right distribution of the resources
driven by high cost and pressure from the state. Medical supplies have been witnessing a steep
rise in price for it is present in a limited amount in society (2). Many researchers have proposed
various solutions based on multiple aspects, however, the topic is debatable, and experts view it
from different perspectives. Also, the issue is not only questionable but also about setting the
priority. On what basis patients should be prioritized to become more eligible to receive medical
resources than the other patient (3). Although healthcare providers demands for more resources
as per the judiciary one of the key factors of health system performance is the decision of
determining appropriate priority. Under the broad aspect of resource distribution, one of the
branch topics is prioritizing available resources for the care of children versus care for elderly.
This essay presents a perspective of prioritizing resource allocation between children and the
elderly. The essay also discusses the ethical issues that may arise in the decision making of
resource allocation for the care of the elderly and the care of children.
Priority setting and resource allocation:
All the health organizations across the world are required to set priorities to allocate
resources among the patients within the limited funding available to them. The health
organizations have the responsibility to meet the health needs of the population as best as
possible (4). However, due to limited resources, it is often not possible to provide the pre-defined
2HEALTH ECONOMICS
population with every need. The issue has grabbed the attention of various healthcare
researchers, and the problems are studied worldwide to bring a solution to it. Resources are
scarce and limited, and there are more claims of resources than actual resources presence to the
healthcare organization (5). Therefore, the healthcare organizations are continually demanding
for more supplies from the nation and the nation constantly pressurize the healthcare to make
appropriate decisions while allocating the limited resources. Also, it is of very much significance
to say that there will always be the need to prioritize before allocating resources regardless of
any amount of resources (6). The decision makers have various grounds on which they decide
the priority for allocating resources. Researches have shown that the decisions makers were often
assisted for priority setting and many times the allocation in the health organizations were
conducted on the basis of political or historical patterns that interprets as the sub-optimal use of
resources.
Age as a factor:
Age has been one of the criteria that is used as the basis of decision making for
prioritizing health services. A patient’s age is often considered as the main criteria when the
health experts decide on the distribution of resources (7). There arises the question that is asking
reasons for preference of elderly patients over the young ones or the younger patients over the
elderly. The problem is for giving priority to age as a criterion that would determine the
allocation of medical services. The biological age gets more importance than the chronological
age frequently (8). However, assuming age as the factor determining the decision which age
group should be given the priority? Also, why should the elderly patients be preferred than the
young ones or the young patients be preferred over the elderly? Also, how would one prioritize
population with every need. The issue has grabbed the attention of various healthcare
researchers, and the problems are studied worldwide to bring a solution to it. Resources are
scarce and limited, and there are more claims of resources than actual resources presence to the
healthcare organization (5). Therefore, the healthcare organizations are continually demanding
for more supplies from the nation and the nation constantly pressurize the healthcare to make
appropriate decisions while allocating the limited resources. Also, it is of very much significance
to say that there will always be the need to prioritize before allocating resources regardless of
any amount of resources (6). The decision makers have various grounds on which they decide
the priority for allocating resources. Researches have shown that the decisions makers were often
assisted for priority setting and many times the allocation in the health organizations were
conducted on the basis of political or historical patterns that interprets as the sub-optimal use of
resources.
Age as a factor:
Age has been one of the criteria that is used as the basis of decision making for
prioritizing health services. A patient’s age is often considered as the main criteria when the
health experts decide on the distribution of resources (7). There arises the question that is asking
reasons for preference of elderly patients over the young ones or the younger patients over the
elderly. The problem is for giving priority to age as a criterion that would determine the
allocation of medical services. The biological age gets more importance than the chronological
age frequently (8). However, assuming age as the factor determining the decision which age
group should be given the priority? Also, why should the elderly patients be preferred than the
young ones or the young patients be preferred over the elderly? Also, how would one prioritize
3HEALTH ECONOMICS
while establishing the medical services and resources depending on the age? It is a critical as
well as a crucial determinant to discuss and come to a concrete conclusion since along with
limited medical resources there are many more aspects related to it (9).
Decision making:
Health is often considered as the fundamental right where everyone is liable and equally
deserve the right the health (10). Although age is used as a criterion to make decisions on the
healthcare distribution, it is considered inappropriate by many debaters. According to the
commenters, a person’s age cannot define the value of life. Moreover, regulating access on the
basis of age is against the philosophy of egalitarian followed in society, the principle of all
human life is sacred and equally deserving of protection (11). Allocating health resources cannot
be based on age for the principle of a natural lifespan. The goal of establishing an age that is
acceptable after which limiting health care should be able to explain the reason for creating
homogeneity in the heterogeneous society. A person’s age cannot determine the value of the
person’s life. It is hard to develop a generalized idea of calculating human life value as the
contribution made by the older citizens varies to a large extent. It is difficult to assume the elder
citizen’s contribution towards the society and to make any attempt to value the human life on
age, and natural lifespan would not be possible. Also, in the healthcare field, a significant portion
is covered by the elderly only as older citizens are prone to illness and disability. The elderly
seek the healthcare more frequently than the children, and it is to be accepted that the elderly are
equally liable to claim for healthcare resources (12).
while establishing the medical services and resources depending on the age? It is a critical as
well as a crucial determinant to discuss and come to a concrete conclusion since along with
limited medical resources there are many more aspects related to it (9).
Decision making:
Health is often considered as the fundamental right where everyone is liable and equally
deserve the right the health (10). Although age is used as a criterion to make decisions on the
healthcare distribution, it is considered inappropriate by many debaters. According to the
commenters, a person’s age cannot define the value of life. Moreover, regulating access on the
basis of age is against the philosophy of egalitarian followed in society, the principle of all
human life is sacred and equally deserving of protection (11). Allocating health resources cannot
be based on age for the principle of a natural lifespan. The goal of establishing an age that is
acceptable after which limiting health care should be able to explain the reason for creating
homogeneity in the heterogeneous society. A person’s age cannot determine the value of the
person’s life. It is hard to develop a generalized idea of calculating human life value as the
contribution made by the older citizens varies to a large extent. It is difficult to assume the elder
citizen’s contribution towards the society and to make any attempt to value the human life on
age, and natural lifespan would not be possible. Also, in the healthcare field, a significant portion
is covered by the elderly only as older citizens are prone to illness and disability. The elderly
seek the healthcare more frequently than the children, and it is to be accepted that the elderly are
equally liable to claim for healthcare resources (12).
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4HEALTH ECONOMICS
Economic priority:
The expensive treatment and medical resources to be spent on the elderly are also seen a
decline in productivity in the later years. To define precisely, the investment is in the aged
population that will not give any long-term returns. Since the medical resources are very high in
cost and it is indeed needed to be used on much rationalization, the commenters are found
spending on the elderly population as a less preferred option. In a simple calculation, the
decisions are made on the return theory. According to the return theory, the calculation is to
invest the resources spend on the elderly should be spent on the patients who have the potential
to give benefit to the nation. Also, another part of the perspective is to allow every citizen the
same span of time to live like others. The health care resources and services should be provided
to the elderly only till the age which is considered the same as the other elderly. By the process
of limiting funds for the elderly will contribute as a way to allow the elderly to reach a certain
age (13). The age-based distribution of healthcare services also argues that it is a way of creating
‘new natural lifespan’ in a country. The health care provided to the elderly is also seen as one of
the primary reason due to which the children do not get the adequate care in the healthcare
services with a bigger problem in the long-term. Also, in this argument, another point is that an
older person has less chance of achieving a successful clinical outcome. Therefore it is assumed
that resources spend on elderly is merely spent on care for the dying elderly.
Strength and weakness:
Health cannot be called as an absolute condition however, factors such as age evaluate it.
To meet the rising curb of meeting the health needs, it is important to make rational decisions
regarding the allocation of medical services. The distribution of health care resources is
Economic priority:
The expensive treatment and medical resources to be spent on the elderly are also seen a
decline in productivity in the later years. To define precisely, the investment is in the aged
population that will not give any long-term returns. Since the medical resources are very high in
cost and it is indeed needed to be used on much rationalization, the commenters are found
spending on the elderly population as a less preferred option. In a simple calculation, the
decisions are made on the return theory. According to the return theory, the calculation is to
invest the resources spend on the elderly should be spent on the patients who have the potential
to give benefit to the nation. Also, another part of the perspective is to allow every citizen the
same span of time to live like others. The health care resources and services should be provided
to the elderly only till the age which is considered the same as the other elderly. By the process
of limiting funds for the elderly will contribute as a way to allow the elderly to reach a certain
age (13). The age-based distribution of healthcare services also argues that it is a way of creating
‘new natural lifespan’ in a country. The health care provided to the elderly is also seen as one of
the primary reason due to which the children do not get the adequate care in the healthcare
services with a bigger problem in the long-term. Also, in this argument, another point is that an
older person has less chance of achieving a successful clinical outcome. Therefore it is assumed
that resources spend on elderly is merely spent on care for the dying elderly.
Strength and weakness:
Health cannot be called as an absolute condition however, factors such as age evaluate it.
To meet the rising curb of meeting the health needs, it is important to make rational decisions
regarding the allocation of medical services. The distribution of health care resources is
5HEALTH ECONOMICS
performed typically on a macro level where the effect is usually on only statistic lives. A
common ground on which decisions are made for the distribution of resources is through
political processes. Government plays a vital role in this process as the decisions pertaining to
healthcare spending and funds regarding healthcare expenditure lies with them. Rationalizing the
decision is the major part of this process which is not conducted appropriately or often it fails to
satisfy the public. The rationalizing the decision should be strict and should be able to convince
the public. The choice of allocating the resources should be based on the need and not the age.
The decisions made on the proper rationalization are also even seen through skeptical views for
the fact people fail to understand the reasons. The older people are often susceptible to rationing
efforts. It is argued that according to the rationalization it is not much in for the care of older
adults. Therefore, there is a restriction in high technology, expensive treatment, life-sustaining
when the elderly people are concerned (14). The principle that is implicit in the argument is that
in the care of elderly people it takes an investment of scarce resources however there is not
assured return or minimal return.
Ethical issues:
In a discussion like this where the question is regarding the preference of age group in a
medical setting, it is bound to come across the ethical aspects. Elderly are always more prone to
illness and disability than children, and therefore they demand special attention regarding
healthcare. One of the notable point under the ethical issue is that no matter how much resources
are available to the healthcare providers it is unlikely to give support to persons who are unable
to pay (15). Often the elderly are not preferred for care in healthcare as they are not economically
productive and they will not be able to pay for the expensive healthcare. The consumerist image
performed typically on a macro level where the effect is usually on only statistic lives. A
common ground on which decisions are made for the distribution of resources is through
political processes. Government plays a vital role in this process as the decisions pertaining to
healthcare spending and funds regarding healthcare expenditure lies with them. Rationalizing the
decision is the major part of this process which is not conducted appropriately or often it fails to
satisfy the public. The rationalizing the decision should be strict and should be able to convince
the public. The choice of allocating the resources should be based on the need and not the age.
The decisions made on the proper rationalization are also even seen through skeptical views for
the fact people fail to understand the reasons. The older people are often susceptible to rationing
efforts. It is argued that according to the rationalization it is not much in for the care of older
adults. Therefore, there is a restriction in high technology, expensive treatment, life-sustaining
when the elderly people are concerned (14). The principle that is implicit in the argument is that
in the care of elderly people it takes an investment of scarce resources however there is not
assured return or minimal return.
Ethical issues:
In a discussion like this where the question is regarding the preference of age group in a
medical setting, it is bound to come across the ethical aspects. Elderly are always more prone to
illness and disability than children, and therefore they demand special attention regarding
healthcare. One of the notable point under the ethical issue is that no matter how much resources
are available to the healthcare providers it is unlikely to give support to persons who are unable
to pay (15). Often the elderly are not preferred for care in healthcare as they are not economically
productive and they will not be able to pay for the expensive healthcare. The consumerist image
6HEALTH ECONOMICS
is adapted by several physicians and patients where the knowledge and skills are sold only to the
one capable of paying for it. A contractual model of medical care overlooks the moral and ethical
considerations (16). Even for the profit of the hospitals' decisions are often made on the rational
choice are built neglecting the ethical aspects. Several countries should be offended by
conducting patient dumping, mostly the elderly. Healthcare should be able to keep the ethics of
fairness such as self-respect, achievement of the elderly, the contribution of the elderly and
respect for wisdom in place when society gives adequate resources and permit to make the profit
in any community. There should be respect for the elderly and dignity to eliminate the mere
reason of supporting consumerist behavior. The only way of bringing this into practice is by
restricting physicians, hospitals and healthcare providers who only aim at making profit and care
for elderly as a condition for doing business. The society needs to act to prevent the healthcare
providers from working without ethics of fairness, and it is only then when the elderly as patient
dumping will diminish.
Conclusion:
The only reason for discussing the distribution of health care services and resources is
due to the fact that there are inadequate resources. It an unavoidable consequence it needs an
appropriate solution and approach to the problem. The decision of allocating medical resources
solely depends on society's perception of viewing the value of the elderly and the capabilities of
the community. For example, a culture that holds high values regarding its elderly age group will
make its decision of allocating based on similar perspectives. This process of decision making
inevitably includes societal values in policy formulation, especially for the treatments which
require expensive health resources for the elderly. Although making the social perception the
is adapted by several physicians and patients where the knowledge and skills are sold only to the
one capable of paying for it. A contractual model of medical care overlooks the moral and ethical
considerations (16). Even for the profit of the hospitals' decisions are often made on the rational
choice are built neglecting the ethical aspects. Several countries should be offended by
conducting patient dumping, mostly the elderly. Healthcare should be able to keep the ethics of
fairness such as self-respect, achievement of the elderly, the contribution of the elderly and
respect for wisdom in place when society gives adequate resources and permit to make the profit
in any community. There should be respect for the elderly and dignity to eliminate the mere
reason of supporting consumerist behavior. The only way of bringing this into practice is by
restricting physicians, hospitals and healthcare providers who only aim at making profit and care
for elderly as a condition for doing business. The society needs to act to prevent the healthcare
providers from working without ethics of fairness, and it is only then when the elderly as patient
dumping will diminish.
Conclusion:
The only reason for discussing the distribution of health care services and resources is
due to the fact that there are inadequate resources. It an unavoidable consequence it needs an
appropriate solution and approach to the problem. The decision of allocating medical resources
solely depends on society's perception of viewing the value of the elderly and the capabilities of
the community. For example, a culture that holds high values regarding its elderly age group will
make its decision of allocating based on similar perspectives. This process of decision making
inevitably includes societal values in policy formulation, especially for the treatments which
require expensive health resources for the elderly. Although making the social perception the
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7HEALTH ECONOMICS
deciding factor of allocating the healthcare resources tends to create hindrance in the allocation
process, it will again depend on the society if it is an accepted criterion or not. Therefore, the
decision maker of the resource allocator should take into consideration the public’s perspective
before concluding and before deciding appropriate candidate who is considered deserving. The
main factor affecting the decision is the putting economic reasons as the priority and not the
ethics. Therefore, the proper solution would only be able to develop when the ethics would be
put in the priority setting.
deciding factor of allocating the healthcare resources tends to create hindrance in the allocation
process, it will again depend on the society if it is an accepted criterion or not. Therefore, the
decision maker of the resource allocator should take into consideration the public’s perspective
before concluding and before deciding appropriate candidate who is considered deserving. The
main factor affecting the decision is the putting economic reasons as the priority and not the
ethics. Therefore, the proper solution would only be able to develop when the ethics would be
put in the priority setting.
8HEALTH ECONOMICS
References:
1. Bakman A, Panov S, inventors; Quest Software Inc, assignee. Method, system and
apparatus for managing, modeling, predicting, allocating and utilizing resources and
bottlenecks in a computer network. United States patent US 8,903,983. 2014 Dec 2.
2. Kahneman D, Tversky A. Choices, values, and frames. InHandbook of the Fundamentals
of Financial Decision Making: Part I 2013 (pp. 269-278).
3. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, Clark PE, Davis BJ,
Derweesh IH, Giambarresi L, Gervais DA. Renal mass and localized renal cancer: AUA
guideline. The Journal of urology. 2017 Sep 1;198(3):520-9.
4. Davies JC. Comparing environmental risks: tools for setting government priorities.
Routledge; 2014 Apr 4.
5. Smith N, Mitton C, Davidson A, Williams I. A politics of priority setting: Ideas, interests
and institutions in healthcare resource allocation. Public Policy and Administration. 2014
Oct;29(4):331-47.
6. Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated
preference studies reporting public preferences for healthcare priority setting. The
Patient-Patient-Centered Outcomes Research. 2014 Dec 1;7(4):365-86.
7. Gu Y, Lancsar E, Ghijben P, Butler JR, Donaldson C. Attributes and weights in health
care priority setting: a systematic review of what counts and to what extent. Social
Science & Medicine. 2015 Dec 1;146:41-52.
References:
1. Bakman A, Panov S, inventors; Quest Software Inc, assignee. Method, system and
apparatus for managing, modeling, predicting, allocating and utilizing resources and
bottlenecks in a computer network. United States patent US 8,903,983. 2014 Dec 2.
2. Kahneman D, Tversky A. Choices, values, and frames. InHandbook of the Fundamentals
of Financial Decision Making: Part I 2013 (pp. 269-278).
3. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, Clark PE, Davis BJ,
Derweesh IH, Giambarresi L, Gervais DA. Renal mass and localized renal cancer: AUA
guideline. The Journal of urology. 2017 Sep 1;198(3):520-9.
4. Davies JC. Comparing environmental risks: tools for setting government priorities.
Routledge; 2014 Apr 4.
5. Smith N, Mitton C, Davidson A, Williams I. A politics of priority setting: Ideas, interests
and institutions in healthcare resource allocation. Public Policy and Administration. 2014
Oct;29(4):331-47.
6. Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated
preference studies reporting public preferences for healthcare priority setting. The
Patient-Patient-Centered Outcomes Research. 2014 Dec 1;7(4):365-86.
7. Gu Y, Lancsar E, Ghijben P, Butler JR, Donaldson C. Attributes and weights in health
care priority setting: a systematic review of what counts and to what extent. Social
Science & Medicine. 2015 Dec 1;146:41-52.
9HEALTH ECONOMICS
8. Baker R, Wildman J, Mason H, Donaldson C. Q‐ing for health—A new approach to
eliciting the public's views on health care resource allocation. Health economics. 2014
Mar;23(3):283-97.
9. van Exel J, Baker R, Mason H, Donaldson C, Brouwer W, Team E. Public views on
principles for health care priority setting: Findings of a European cross-country study
using Q methodology. Social science & medicine. 2015 Feb 1;126:128-37.
10. Tanios N, Wagner M, Tony M, Baltussen R, van Til J, Rindress D, Kind P, Goetghebeur
MM. Which criteria are considered in healthcare decisions? Insights from an international
survey of policy and clinical decision makers. International journal of technology
assessment in health care. 2013 Oct;29(4):456-65.
11. Smith S, Nolan A, Normand C, McPake B. Health economics: an international
perspective. Routledge; 2013 Jun 7.
12. Cornelissen E, Mitton C, Davidson A, Reid RC, Hole R, Visockas AM, Smith N.
Changing priority setting practice: The role of implementation in practice change. Health
Policy. 2014 Aug 1;117(2):266-74.
13. Smith S, Nolan A, Normand C, McPake B. Health economics: an international
perspective. Routledge; 2013 Jun 7.
14. Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated
preference studies reporting public preferences for healthcare priority setting. The
Patient-Patient-Centered Outcomes Research. 2014 Dec 1;7(4):365-86.
15. Hirose I, Bognar G. The ethics of health care rationing: an introduction. Routledge; 2014
Jun 5.
8. Baker R, Wildman J, Mason H, Donaldson C. Q‐ing for health—A new approach to
eliciting the public's views on health care resource allocation. Health economics. 2014
Mar;23(3):283-97.
9. van Exel J, Baker R, Mason H, Donaldson C, Brouwer W, Team E. Public views on
principles for health care priority setting: Findings of a European cross-country study
using Q methodology. Social science & medicine. 2015 Feb 1;126:128-37.
10. Tanios N, Wagner M, Tony M, Baltussen R, van Til J, Rindress D, Kind P, Goetghebeur
MM. Which criteria are considered in healthcare decisions? Insights from an international
survey of policy and clinical decision makers. International journal of technology
assessment in health care. 2013 Oct;29(4):456-65.
11. Smith S, Nolan A, Normand C, McPake B. Health economics: an international
perspective. Routledge; 2013 Jun 7.
12. Cornelissen E, Mitton C, Davidson A, Reid RC, Hole R, Visockas AM, Smith N.
Changing priority setting practice: The role of implementation in practice change. Health
Policy. 2014 Aug 1;117(2):266-74.
13. Smith S, Nolan A, Normand C, McPake B. Health economics: an international
perspective. Routledge; 2013 Jun 7.
14. Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated
preference studies reporting public preferences for healthcare priority setting. The
Patient-Patient-Centered Outcomes Research. 2014 Dec 1;7(4):365-86.
15. Hirose I, Bognar G. The ethics of health care rationing: an introduction. Routledge; 2014
Jun 5.
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10HEALTH ECONOMICS
16. Marsh K, Lanitis T, Neasham D, Orfanos P, Caro J. Assessing the value of healthcare
interventions using multi-criteria decision analysis: a review of the literature.
Pharmacoeconomics. 2014 Apr 1;32(4):345-65.
16. Marsh K, Lanitis T, Neasham D, Orfanos P, Caro J. Assessing the value of healthcare
interventions using multi-criteria decision analysis: a review of the literature.
Pharmacoeconomics. 2014 Apr 1;32(4):345-65.
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