The allocation of health care resources is possibly the most significant ethical challenge in health care, although it is not often perceived as such by the general public. Decisions about allocation of resources provide significant insight into how an organization translates its values->organizational values into practice; it is not a stretch to claim that the most significant ethical document an organization produces is its budget and business plan.
Resource allocation in health care is a zero sum game in a meaningful way; decisions that generate benefit for one group preclude generating benefit for another group, raising concerns about justice in these allocations.
In health care we are concerned not just about the use of funds but also the allocation of space, equipment, and health care provider time. Resource allocation decisions are deeply ethical in that they significantly determine how individuals are treated (or not) by the health care system.