Medical Queue Jumping

A major advantage of living in the developed world is that there is access to health care, but an increasing worry surrounds the current debate as how to pay for it as the technology improves and becomes more expensive. The age demographic of many populations is bringing this into sharper focus.

Before we get to decisions on rationing, there are questions on prioritizing or putting people to the back of the queue, that is posteriorizing them. Diederich et al decided to ask 1915 German citizens for their preferences should the costs of health care force changes. Their results are in the current issue of the Public Library of Science (1).

The good citizens were given two sets of criteria onwhich to base their prioritization or not as the case may be. The first set were health-based issues such as acute illness, life threatening conditions, chronic conditions, age etc.

The second set was the patient’s socio-economic status with issues such as high income, social responsibility, working age, professional responsibility, etc.

In general, serious illness and children were accepted as priority cases, whilst things like having a high income or being socially active were certainly not reasons to be given priority. These are views that most of us would espouse in public, but there was a lot more granularity when the participants were grouped in terms of having a healthy lifestyle, their socio-economic status, age or current health status.

For example the lower socio-economic group were coupled with those living a healthy life style in that they were keener on giving priority to seniors, children and people with children. The old codgers were less happy with priority to children or to people with children. The young people were more likely to support priority for people with mental handicaps.

When you start digging it looks like medical queue jumping won’t be generally popular, but would be tolerated for the very sick and maybe some kids, but even then there would be some muttering. Clearly, the size of your bank balance should not influence the triage. It appears that we need to find better solutions – could there be solutions via our smartphones and robots?


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