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Distributing medical resources

An application of cooperative bargaining theory to an allocation problem in medicine


Antje Köckeritz

Allocating scarce medical resources has become an important topic in public discussion. In the German statutory health system we are facing a situation of lacking adequate funds for all needs. The financial restrictions force us to use resources wisely. This emphasizes the need of general allocation rules and criteria applied in medical allocation situations. The purpose of this work is to implement and interpret properties of cooperative bargaining theory to special allocation situations in medicine. The author shows how the concepts of Nash and Kalai/Smorodinsky can be applied to a medical allocation problem and discusses implications of their properties and solutions for the German health system.


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3 A cooperative bargaining model for two groups of patients


3.1 Introduction The model in this chapter refers to a medical allocation problem that has been discussed in philosophic literature since the late 70ies of the 20th century. In detail, the Parfit-Taurek discussion (e.g. in Lübbe (2004)) is about Taurek’s example of saving the lives of 5 individuals versus the life of 1 with the same amount of medicine. This illustrates a dilemma situation in allocating medical resources to patients. Ahlert (2006) generalizes Taurek’s example in health economics and defines an allocation problem with a finite number of patients who each have an individual need. The total amount of the medical good does not suffice to fulfill all needs. This chapter considers this type of models and defines and analyzes solutions to such allocation situations. We apply cooperative bargaining theory and characterize allocation mechanisms by their normative properties. Finding solutions to the described allocation problem one may consider different solution concepts. First, we may apply a stochastic process that chooses patients with a certain probability. Ahlert (2006) and Ahlert (2009) define such a random mechanism for the allocation problem. A second approach considers allocating medical resources according to a priority list as proposed by Ahlert (2005) and Zimmermann (2009). Finally, we contribute to the discussion by applying a cooperative bargaining approach to the allocation problem. That is, we model the allocation problem as a bargaining problem and we claim normative axioms for a solution that are derived from cooperative bargaining theory. In particular, we focus on the bargaining concepts...

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