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 ![[Horizontal Rule]](/webart/nav_rule.gif){kind=small}            Click here to learn about |
 ![[----------------Horizontal Rule----------------]](/webart/hrule.gif){kind=small}  Article 2: Rationing Health Care: How will AAC Fare?Being proactive: Health care rationing & assistive technology. While countries don't approach health care or education with the same set of assumptions, governments are facing similar realities and issues with regard to assistive technology services and devices. · laws are creating a greater demand for services and equipment; · technological options are increasing; · governmental resources are dwindling; and · health-care and education systems are being challenged. For example, in the U.S., more than 20 percent of the population is not covered by health insurance. Of those who have insurance, a substantial portion are on public assistance. This means that many U.S. citizens have limited access to health care. In Canada and other countries with socialized medicine, citizens are entitled to receive health-care services and are taxed highly to accommodate costs. Even so, who receives services and the type of services delivered do vary. For example, AAC "services" can mean a prescription for equipment in one area (or for one group); and in other places (or for other groups) may mean easy access to comprehensive services and assistive technology. Even when a high level of commitment, public laws, and a desire to deliver assistive technology services exist, delivery systems and funding mechanisms are not set up to provide technology and related services to everyone with a severe communication disorder. Nor, one might argue, should they be. Not only are there other priority areas (social, health, education) to consider, but not everyone wants or benefits from AAC. Resources and efficiency suggest we cannot make equal commitments to all issues at the same time. We all have to establish priorities. When governmental resources become scarce, the term used for setting priorities becomes "rationing." Rationing means "a fixed portion or share and is associated with scarcity." We are hearing more and more about "health-care rationing." These discussions raise important moral and ethical issues that are difficult, at best, to deal with. However, we really do need to figure out how best to allocate available resources, i.e., who can benefit, and who gets what, under what circumstances. The AAC community can take a proactive role and work with funding agencies to: 1.Identify the populations for whom technology is appropriate and conduct outcome studies. 2. Look at alternative service delivery systems. 3. Look at costs in different settings. Consider a cost benefit analysis for assessment, training and delivery of technology. 4. Provide some standardization, i.e., establish best practice patterns given the multitude of settings. See News on page 8 of Volume 4, # 6 for a step in that direction. 5. Identify research priorities within the AAC community and consider these from a perspective of what we should be funding
This article appears in ACN Volume 4, # 6. You may order this
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