Rationing between health care needs is unavoidable. Such rationing ought to be morally justified. In order to be morally justified rationing must be nondiscriminatory and cost-effective. However, generally resources spent on old and disabled people are spent less cost-effectively, ceteris paribus, than resources spent on young and non-disabled people, since they can expect to enjoy fewer, extra quality adjusted (e.g., QALYs) life-years. Yet since giving lower priority to such groups can be discriminatory, we face a health care trilemma involving the following three claims:

1. A morally justified scheme of health care rationing does not discriminate against any groups (The Non-Discrimination Claim).

2. A morally justified scheme of health care rationing is cost-effective (The Cost-Effectiveness Claim).

3. A cost-effective health care rationing scheme discriminates against old people and disabled people (The Incompatibility Claim). 

This project explores how we should respond to the healthcare trilemma.