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| Introduction | |
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| Is It Nice to Ration? | |
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| Putting a Price on Your Life | |
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| The Pressure to Ration | |
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| Cutting to the Chase | |
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| Rationing Drugs Down Under | |
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| The National Institute for Clinical Excellence (Nice) | |
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| The Beta-Interferon Controversy | |
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| Medicine Versus Economics | |
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| Endnotes | |
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| Defending Rationing in Principle | |
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| Rationing and Toy Shopping | |
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| Are We Wasting Money on Health Care? | |
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| Moral Hazard | |
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| The Rand Study | |
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| Demand Inducement | |
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| Bad Buys in Health Care | |
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| The Wennberg Variations | |
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| Defending Rationing | |
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| Endnotes | |
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| Rationing Around the World | |
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| Rationing in Germany | |
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| Controlling Drug Costs in Germany | |
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| If It Looks Like Rationing | |
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| Rationing in Canada | |
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| The Consequences of Waiting Lists | |
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| The Future of Rationing in Canada | |
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| Rationing in England | |
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| Rationing Elsewhere in the World | |
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| Endnotes | |
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| Rationing in the U.S. Health Care Marketplace | |
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| Rationing Through the Market Mechanism: The Uninsured in the United States | |
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| Attempts to Provide Universal Coverage | |
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| Rationing Among Insured Americans | |
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| Government-Sponsored Rationing in the United States | |
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| A Brief History of Managed Care | |
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| MCO Strategies for Containing Costs | |
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| Whither Rationing in America? | |
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| Enough Is Enough | |
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| Endnotes | |
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| Doing Cost-Effectiveness and Cost-Benefit Research | |
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| Some Background on CEA | |
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| Is It Valid to Use CEA for Health Care? | |
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| Doing CEA/CBA | |
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| Measuring Costs | |
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| Discounting | |
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| Is CEA/CBA Research Valid? | |
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| CBA/CEA in Practice | |
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| Endnotes | |
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| Measuring the Quality of Life | |
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| Using Rating Scales to Measure Health States | |
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| Working with QALYs | |
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| Putting QALYs into Practice | |
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| All QALYs Are Equal | |
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| Measuring QALYs | |
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| How Do Your QALY Scores Measure Up? | |
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| The Quality of Well-Being (QWB) Scale | |
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| Concerns about QALYs | |
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| Discrimination and QALYs | |
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| Limitations of QALY Surveys | |
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| Summing Up CEA/CBA Methods | |
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| What about the PSA Test? | |
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| Endnotes | |
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| The Oregon Plan | |
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| Rationing in Oregon | |
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| The Story of Coby Howard | |
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| Toward a Rational Rationing Plan | |
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| The Creation of the Oregon Health Plan | |
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| The Oregon Plan and HMOs | |
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| Creating the List | |
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| The New List | |
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| More Protests | |
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| The Performance of the Rationing Plan | |
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| Oregon Ten Years Later | |
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| Where Do We Draw the Line? | |
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| Endnotes | |
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| What Is Your Life Worth? | |
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| Willingness to Pay, Human Capital, and Intrinsic Value | |
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| Pricing Life in the Real World | |
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| The Cost-of-Illness (COI) Approach | |
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| Using Surveys to Put a Price on Good Health | |
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| Some WTP Measures | |
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| Willingness to Pay for Life | |
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| How Useful Are WTP Measures? | |
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| Statistical Versus Identifed Lives | |
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| The Economic Approach to Valuing Statistical Lives | |
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| Other Evidence on the Value of Life | |
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| What Is Your Life Worth? | |
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| Value of a QALY | |
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| Responding to Mr. Mortimer | |
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| The Bottom Line | |
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| Endnotes | |
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| Rising Costs and Rational Rationing | |
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| The Health Care Budget "Crisis" | |
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| The Drain on the U.S. Economy | |
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| Targeting Technology | |
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| The Fallacy of Cost Containment | |
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| The Steady Drumbeat of Rational Rationing | |
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| Can Patients Be Rational? | |
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| Who Should Ration? | |
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| Rational Rationing in the Public Sector | |
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| Rational Rationing and Managed Care | |
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| The Real Obstacles | |
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| Rational Rationing in the 21st Century | |
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| Endnotes | |
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| Index | |