5 Dec 2022


Allocation Principles in the US Healthcare System

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Role of Allocation Principles 

The American healthcare system is facing medical resource scarcity, especially due to the increased life expectancy, limited health budgets, and the continuous physical shortages of the resources. Even as the aging population continues to increase, there is a need to provide limited medical resources to both the aging and the young population. However, it can seem impossible to meet the health needs of all this group of people at once with the existence of limited resources. Allocation of the limited healthcare resources to the large population who are in demand, therefore, requires making decisions are ethically right, and that seems to promote fairness and equality by considering the necessary factors (Persad, Wertheimer & Emanuel, 2015). Allocation principles play a key role in helping in the allocation of scarce healthcare resources to people in a way that seems ethical and promote equality. 

Because it is challenging to meet the medical needs of all the individuals, ethicists through the allocation principles, provide normative guidance on how to fairly allocate these scarce resources. While what amounts to ethical allocation and fairness varies depending with individuals, allocation principles provide some direction which can be considered sufficient for allocation, even though no single allocation principle can be considered entirely sufficient thus the need for a multiprinciple allocation approach. Principles such as lottery promote the idea of treating everyone equally while allocating scarce medical resources (Persad, Wertheimer & Emanuel, 2015). The allocation principles of favoring the worse-off, on the other hand, advocates for allocation based on the sickest first or the youngest first. Even though each of the allocation principles cannot be considered to lack flaws, they play a crucial role in providing direction on what kind of allocation model seems ethical and fair for all. The principles help reduce the ethical dilemma that the healthcare sector faces while allocating scarce resources to the larger population, especially as the aging group increases. 

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Implications on the Aging Population 

The allocation principles advocate for the ethical mode of resource allocations in different ways. The aging population is increasing, and the controversy surrounding the principles of allocation could mean that in some cases, the aging population may not receive the treatment when they need it most. The principle of favoring the worse-off, which views giving priority to the youngest, and the sickest first could mean that the aging population would not get priority when for medical treatment. The federal law specifically protects individuals from any form of health care discrimination. Any person who qualifies for the federal health insurance programs should not be subjected to discrimination based on gender, race, or even age (Avraham, Logue & Schwarcz, 2014). As a result, some principles which prioritize the provision of care based on age can violate the federal anti-discriminatory laws. 

The allocation principles that prioritize the first allocation to the younger generation can have a serious health impact on the aging population. As more Americans reach the age of 65 and above, the need for them to receive care services is also increasing amid strained scarce medical resources. The implication is that its aging population would not have priority or even equal opportunity to access care services. The ethical principles of fair treatment require that all patients are treated with fairness and equality and that they are not discriminated against based on any factor, including their age (Avraham, Logue & Schwarcz, 2014). This could predict more ethical dilemma in the allocation of resources and provision of care for the aging population. 

Complete Lives System 

Based on the complete lives system of allocation, the individual most likely to receive surgery is Steve McDonald, who is 40 years old unemployed musician. The complete lives system is based on the combination of the five major principles, which include the Youngest First, Prognosis, Save the Most Lives, Lottery, and Instrumental Value. The major goal of the complete lives system is to achieve complete lives by basically redistributing the life years from older individuals to the younger ones ( Huntoon, 2013 ). The central to this system is to create a system that limits care to older individuals in favor of younger people. Amongst the three patients in the case study, MacDonald is the youngest and a man who still have dreams of accomplishing his music career. The remaining two are over 55 years and have probably lived and accomplished most of their life goals. 

The complete lives system is a multiprinciple approach that takes into consideration many other principles to reduce the insufficiency. It is not an age discriminatory system because all people are subject to aging, and the older individuals have already lived much of their younger lives. In this principle, the children and infants are deemed less worthy than adolescents in receiving medical care because of the belief that society has invested a lot in them compared to infants ( Huntoon, 2013 ). It provides age as a great objective measure to be used during the allocation of scarce resources. It favors people who are within the age bracket of 15-40 as they are considered productive and more useful in the development of the society compared to those who fall outside this age bracket. 

Moral, Ethics and Healthcare Laws 

The person I would recommend for surgery is Steve MacDonald, who is a 40-year older adult with ambitions to prosper in his music career. Based on the ethical principle of allocation for prioritarianism with a focus on the youngest first, Steve is the youngest unemployed man who has not lived up to his life and expectations. He is still struggling to pursue his career and get to the public domain. He has a teenage son who could still need the fatherly figure and support from him, unlike the other patients who have no children. The two other patients have lived past 55 years and have accomplished most of their life goals. Steve is still young and a potential figure for the growth and mentoring of young people through his music career. There is a need to balance life between the old and younger people. Young people are the future of any economy due to their productive abilities compared to the aging population. 

Recommended Allocation Principle 

The principle that I would recommend is maximizing the total benefits through saving more lives. This principle is based on the utilitarianism value, which prioritizes saving more lives. It is better to save five lives than one. All lives are valuable irrespective of the age, and an attempt to save most lives can be the most ethical and best method for resource allocation. Utilitarianism ethical theory states that the most ethical decision is one that produces the greatest benefit and the least harm to a large number of people. The lives of both the older and young people are worth, and a method that best minimizes the harm and maximizes benefits to a large number of people is the most ethical decision. It is better off to save 100 lives and lose one life because the harm of losing one life is less than that of losing 100 lives. This can be used in the allocations such as vaccination of influenza and response to bioterrorism. This method avoids discrimination and comparing the lives of individuals; it instead focuses on treating all lives to be valuable worth saving. 


Avraham, R., Logue, K. D., & Schwarcz, D. (2014). Towards a Universal Framework for Insurance Anti-Discrimination Laws.  Conn. Ins. LJ 21 , 1. 

Huntoon, L. R. (2013). The complete lives system: socialism in medicine.  Journal of American Physicians and Surgeons 18 (3), 66-68. 

Persad, G., Wertheimer, A., & Emanuel, E. J. (2015). Principles for allocation of scarce medical interventions.  The Lancet 373 (9661), 423-431. 

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