Author Affiliations: Departments of Medicine and Economics, and Harris School of Public Policy Studies, University of Chicago, Chicago, Illinois (Dr Meltzer); and Departments of Health Policy Management and Evaluation and Medicine, University of Toronto, Department of Medicine, Mount Sinai Hospital, and University Health Network, Toronto, Ontario, Canada (Dr Detsky).
Since the inauguration of President Obama in January 2009 and the subsequent passage of the Patient Protection and Affordable Care Act in March 2010, Americans have been saturated with debate about reform of the US health care system. Most of the issues and concepts are not new and focus on whether changes will make the health care system more efficient and equitable. Economists have specific definitions of these 2 attributes. Efficiency refers to the objective of maximizing the amount of goods and services and total societal welfare that are produced with a fixed level of resources. This implies a focus on costs. Equity refers to the distribution of goods and services across individuals in society, measuring who gains and who loses when some policy change occurs.
Meltzer DO, Detsky AS. The Real Meaning of Rationing. JAMA. 2010;304(20):2292–2293. doi:10.1001/jama.2010.1671