Irene Fafaliou, Ph.D., Department of Economics, University of Piraeus, 80, Karaoli & Dimitriou Str, Piraeus, 18534, Greece, Euthalia Tzanalaridou, MSc, in, Health, Cardiac Intervention and Electrophysiology Laboratory, Euroclinic of Athens, 9 Athanasiadou Str., Ambelokipi, Athens, 115 21, Greece, and Apostolos A. Ballas, Ph.D., Department of Accounting & Finance, Athens University of Economics and Business, 76, Patission str, Athens, 10434, Greece.
The rapid technological advances and the ageing of the population are leading to a steady increase in healthcare spending that absorbs an ever-larger percentage of Gross Domestic Product (GDP), worldwide. Eliminating inefficiencies in healthcare systems by evidence can provide short-term fiscal relief, but rationing of beneficial services seems to offer the only prospect for a sustainable public health system. This paper’s aim is: 1st) to explore the choices that have to be made concerning the decision making on rationing in healthcare, 2nd) to shed some light on the methods used to enforce rationing in a public health system, and 3rd) to inform policy-makers on alternatives to rationing measures in accordance with the fundamental principles of the European health systems (i.e. solidarity, equity and fairness). To these ends, a desk and a field research approaches were considered as most appropriate for our research strategies. The desk research is based on a critical overview of rationing methods already implemented in selected advanced countries, whereas the field research is based on material gained through in-depth interviews from “key stakeholders” of the Greek cardiac patients’ group. The findings indicate that rationing is basically a mix rather than a single policy issue, depending on a complicated range of reconciliations made at various levels of interested parties (i.e. system level, program level and patient level). Furthermore, it becomes evident that there is no universal formula to fit all countries’ healthcare systems, but a contingency approach is required in the decision making process. Finally, further research efforts are suggested in the field.