Health care services are "rationed," or distributed in a limited way, in all nations. As the health care environment changes rapidly, competition for resources becomes more intense, insurers continue to consolidate and control many markets, and greater limitations on available funds for health care become a certainty, issues of potential or extant rationing in the United States take on a new urgency. How health care is or might be rationed here, what criteria exist and should be used, what effects are intended, and who should control the process are all increasingly pressing questions. There is much to learn from past practice as well as current concerns and proposals. Rationing of care is examined in its historical, ethical, philosophical, policy, clinical, logistical, social, legal, and administrative contexts. Students participate in class discussion, make an oral presentation, and complete a take-home exam. Extensive readings are involved. Attendance at all sessions is required.

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