Pricing Life: Reviews

The New England Journal of Medicine — Wallace Bergman (April 6, 2000)

In this book, Peter A. Ubel discusses the important and controversial issue of health care rationing in a logical, carefully defined, and well-substantiated manner. He accurately points out that rationing of health care services is essential in any society in which resources are not unlimited. Simply stated, this means that not everyone can have everything he or she wants. Ubel skillfully deals with the ethical and moral dilemmas that result from these limitations. He points out that health care is rationed at many levels — for instance, by federal policy mandates, insurers’ reimbursement policies, and physicians’ decisions at the bedside. Ubel presents a lengthy description of cost-effectiveness analysis, accompanied by a discussion of the pitfalls of this method when it is applied to the rationing of health care services. He notes the frequent discordance between findings derived from cost-effectiveness analysis and those obtained by direct community interviews or surveys. His discussion of his own substantial and innovative research on people’s preferences for the allocation of health care resources is excellent…(Read the rest here)


Perspectives in Biology and Medicine — Robert Veatch (Winter 2001 issue)

On the claim that rationing is ubiquitous and morally necessary, this is quite simply the best thing ever written. It is not that Ubel offers startlingly new analysis. At least for one who is familiar with his provocative and original journal articles, some of which are incorporated into this volume, parts of this story will be familiar — but, especially for the clinician or layperson not already persuaded of the compelling case in favor of rationing — he sets out that case in dramatic, easy-to-grasp, powerful prose. Ubel shows how the old Hippocratic moral dictum that the physician should always to do what is best for the patient leads to impossible and immoral requirements…(Read the rest here)


Journal of Medical Ethics — Søren Holm (Volume 27, Issue 5)

Pricing Life is an extremely timely and stimulating book. The debate about health care rationing has now been running for several decades but there are still people who publicly deny that rationing of health care has to take place, or that health care rationing could be ethically justifiable. In many countries we have also had politicians who have refused to allow the “R” word to pass their lips. In this well written, and very direct book Peter Ubel decisively shows that rationing is an inevitable feature of modern medicine and that it is not something that health care administrators and economists force doctors to perform against their better judgment. Deciding who should have access to treatment has always been a part of the doctor’s work. Ubel’s analysis of the phenomenon of bedside rationing is incisive and definitive. Anyone who will still deny that rationing does and must take place after having read this section can only be in bad faith…(Read the rest here)


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