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Ration End-Of-Life Care

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  • Three Reasons Why We Should Not Ration End-of-Life Care

    Clip: Ken Connor, Chairman of Center for a Just Society, argues why government should not ration end-of-life care in his opening statement.

  • Single Payer Rationing and Caring for the Uninsured

    Clip: Sally Pipes, President and Chief Executive Officer of the Pacific Research Institute, and Dr. Art Kellermann, Chair at Policy Analysis RAND Health, argue about the impact of single payer healthcare rationing on America's poor and uninsured.

  • Peter Singer's Strategy to Ration End-of-Life Care

    Clip: Arguing for the motion, Peter Singer, Professor of Bioethics at Princeton University, provides his strategy for effectively rationing end-of-life care.

  • The Role of Government and the Free Market in Healthcare

    Clip: Ken Connor, Dr. Art Kellermann, and Peter Singer argue what the role of government should be in healthcare, and how free markets influence the nature of care.

Debate Details

Taking place at Chicago Ideas Week:


Just because we can extend life, should we? The U.S. is expected to spend $2.8 trillion on health care in 2012. Medicare alone will cost taxpayers $590 billion, with over 25% going toward patients in their last year of life. If health care is a scarce resource, limited by its availability and our ability to pay for it, should government step in to ration care, deciding whose life is worth saving? In other words, how much is an extra month of life worth?



The Debaters

For the motion

Dr. Art Kellermann

Chair in Policy Analysis, RAND Health

Art Kellermann holds the Paul O'Neill Alcoa Chair in Policy Analysis at the RAND Corporation. Before joining RAND, he was a Professor of emergency... Read More

Peter Singer

Philosopher & Professor of Bioethics, Princeton University

Peter Singer is the Ira W. DeCamp Professor of Bioethics in the University Center for Human Values at Princeton University. He specializes in applied... Read More

Against the motion

Sally C. Pipes

President and Chief Executive Officer of the Pacific Research Institute

Sally C. Pipes is President and Chief Executive Officer of the Pacific Research Institute (PRI), a San Francisco-based think tank founded in 1979... Read More

Ken Connor

Chairman, Center for a Just Society

In 2005, Ken Connor founded the Center for a Just Society, where he serves as the organization’s Chairman. Connor is affiliated with the law firm... Read More

Where Do You Stand?

For The Motion
  • The U.S. spends more on health care than any other industrial nation—in 2012 we are expected to spend $2.8 trillion. We cannot afford our health care system and expensive end-of-life care costs are a major contributor to this problem.
  • Rationing means getting better value for the trillions we spend every year.
  • Rationing already happens. Medicare decides what it will reimburse, private insurance decides what they will cover, and individuals go without care and medicine every day when they can't afford it.
  • We must ration based on cost-effectiveness, not on an individual's ability to pay.
  • If we spent less on those who, with or without treatment, have only a few months left to live, we would be better able to help those who may have decades.
Against The Motion
  • The government should not have the power to determine who lives, who dies, and who gets treatment based on calculations of quality and quantity of life.
  • Health care costs can be reined in without rationing care.
  • Targeting "end-of-life" care specifically would result in very little cost savings.
  • Rationing care will lead us down a moral slippery slope. How many years of life is enough? Who is productive and worthy, and who is not?

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The Research

The Research

End-of-Life Care

Miller Center of Public Affairs and MacNeil/Lehrer Productions
March 24, 2010

Panelists in a Miller Center program debate the motion, ‘The United States must ration costly end-of-life care.’

Must We Ration Health Care for the Elderly?

Daniel Callahan
March 27, 2012

Rationing should be done by policy, not by individual doctors and patients at the bedside, policy must be set by democratic process, policy must be carried out in a transparent way, and there should always be a provision for appeal.

Should Government Determine the Value of Human Life?

Randy Pate
July 21, 2009

In the name of expanding health care insurance to all, the administration and liberals in Congress are quickly leading the country down the road to government-rationed health care—where government holds the power of life and death over every American. In such a system, boards of “experts” will evaluate the relative values of human lives and make coverage decisions accordingly.

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