An application of cooperative bargaining theory to an allocation problem in medicine
In the German statutory health system (GKV) allocating medical resources and keeping finances for medical goods and services in balance has become a strenuous task. Over the past years the increasing number of examination methods and medications as well as the aging of population intensified the trade- off in allocating financial resources to different medical areas. Tragic choices, when medical therapies suffice to treat only a fraction of patients are indeed very common, for example, in intensive care, dialysis treatment, and organ allocation. In following years, as technological progress and demographic change proceed, the competition over medical resources is expected to become even more intense. Therefore, it is important to find fair distribution mechanisms that may eloquently solve the medical allocation problems about scarce resources. Ways to deal with restricted resources for medical goods are manifold: to cut or to withhold services such as nursing time or waiting time for a doctor’s appointment, to increase contribution fees or co-payments, to give incentive to private insurance. So far, the German statutory health system has experienced different changes in selected medical areas. For example, in dental care we have defined minimal services and a system of co-payments and an incentive to private insurance. In a health system with restricted financial resources, several alternatives of keeping the system in balance may be introduced. Yet it is important to understand the consequences of underlying allocation rules their solutions and properties in order to apply in specific medical allocation situations. The question is, which rule...
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