ABSTRACT
This chapter discusses some systematically vague concepts and phrases that are central to the national discussion on health care resource allocation. For many years there have been various ways to specify what should count as a "minimally adequate" level of health care, or a "basic minimum," or a set of "basic benefits," or that which is "medically necessary." The history of the idea of a basic standard of care is interesting in that respect. In 1965, the federal legislation establishing the Medicaid program specified that the indigent were to receive "medically necessary" care. A sensible political process, by contrast, would be one that tried to find as many objective elements as possible: good data, reasonable criteria for their evaluation, a decent system of information-sharing, and so on. Those objective elements would help give shape and substance to the political debate; it would not just be a free-for-all.
