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“If adopted, the approach could have implications for other decisions about how to allocate scarce medical resources, such as expensive cancer drugs…Caplan said.”

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Scarce resources that are in high demand are always rationed. There is a new push to rewrite the rules for the allocation of organs that have been donated to the people who are waiting for them, and the Washington Post has the details.

Lots of candor in the piece from Arthur C. Caplan, a University of Pennsylvania bioethicist:

“This is a fascinating canary-in-a-cave kind of debate,” he said. “We don’t want to talk about rationing much in America. It’s become taboo in any health-care discussion. But kidneys reminds us there are situations where you have to talk about rationing. You have no choice. This may shine a light on these other areas.”

So, who has the power here? The United Network for Organ Sharing (UNOS), a Richmond-based private nonprofit group “contracted by the federal government to coordinate organ allocation.” Ultimately, then, the federal government is running this network and approving the rules, though they are clearly being developed via a highly professional process.

Whether that remains the case under Obamacare and in other situations in which scarcity will govern a resource remains very much in question. Another excellent reason to support the increase in the control of state governments over health care via the Health Care Compact. The more political bodies involved and the more closely connected to the voters, the much more likely the result will reflect the will of a majority of Americans and not just the decisions of a technological and medical elite backed by a federal bureaucracy.

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