This course will explore the complex challenges of allocating scarce medical resources at both the micro and macro level. Students will learn the theories behind allocation and use modern examples to explore how society makes the difficult decisions that arise when there is not enough to go around.
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You have one liver but three patients are awaiting a liver transplant. Who should get the liver? What criteria should be used to select the recipient? Is it fair to give it to an alcoholic? These are some of the questions that arise in the context of rationing and allocating scarce health care resources among particular individuals. These are called micro-allocation decisions. There are also macro-allocation decisions that focus on how health care systems distribute resources across populations. Using the cases of organs for transplantation, the rationing for vaccines in a flu pandemic, and oncology drug shortages, the course will critically examine alternative theories for allocating scarce resources among individuals. Using both the need to establish priorities for global health aid and to define an essential benefit package for health insurance, the course will critically examine diverse theories for macro-allocation from cost-effectiveness analysis to age-based rationing to accountability for reasonableness.
