Concepts of Equity and Fairness in Health and Health Care

2011 ◽  
pp. 813-836 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Distributive Justice ◽  
Personal Responsibility ◽  
Economic Models ◽  
Equality Of Opportunity ◽  
Inequalities In Health ◽  
Equity Issues ◽  
Equity And Efficiency ◽  
Equality Of Opportunities

This article describes the various concepts of equity and fairness that have been developed by economists in health and health care. It begins with a background framework on the principal causes of inequalities in health and health care. It is concerned with equity issues and theories of distributive justice being integrated into health economic models. The discussion of “paradigm of the health frontier” brings equity and efficiency together. It enquires what the key question of equality in terms of stream of health is and is concerned with the equality of opportunities or equality of outcomes. This issue is strongly related to the intricate issue of “personal responsibility.” The renewed interest in the literature on the distinction between equality of opportunity and equality of outcomes, as well as in the notion of responsibility, represents an attempt to clarify the reasons why one type of inequality can be labeled fair, while another be unfair. Finally, the article draws some implications.

Personal Responsibility in Health and Health Care: Luck Egalitarianism as a Plausible and Flexible Approach to Health

2019 ◽  
Vol 73 (3) ◽  
pp. 583-595 ◽  
Author(s):  
Andreas Albertsen
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Distributive Justice ◽  
Personal Responsibility ◽  
Luck Egalitarianism ◽  
Transplant Recipients ◽  
Flexible Approach ◽  
Lower Priority ◽  
Wide Range ◽  
Luck Egalitarian

Allocating health care resources based on personal responsibility is a prominent and controversial idea. This article assesses the plausibility of such measures through the lens of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. This article presents a framework of luck egalitarianism in health, which integrates other concerns of justice than health, is pluralist, and is compatible with a wide range of measures for giving lower priority to those deemed responsible. Applying this framework to oral health, the allocation of livers among potential transplant recipients and travel insurance demonstrates that this version of luck egalitarianism is a much more attractive and flexible theory than much of the contemporary discussion allows. This also pertains to its ability to provide plausible answers to two prominent critiques of harshness and intrusiveness. The discussion also shows that the luck egalitarian commitment to eliminating the influence of luck on people’s lives is likely to require substantial redistribution.

scholarly journals Conceptualising changes to tobacco and alcohol policy as affecting a single interlinked system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duncan Gillespie ◽  
Jenny Hatchard ◽  
Hazel Squires ◽  
Anna Gilmore ◽  
Alan Brennan
Keyword(s):  
Health Economic ◽  
Policy Change ◽  
Conceptual Understanding ◽  
Communicable Disease ◽  
Model Development ◽  
Economic Models ◽  
Alcohol Policy ◽  
Policy System ◽  
The People ◽  
Main Components

Abstract Background To support a move towards a coordinated non-communicable disease approach in public health policy, it is important to conceptualise changes to policy on tobacco and alcohol as affecting a single interlinked system. For health economic models to effectively inform policy, the first step in their development should be to develop a conceptual understanding of the system complexity that is likely to affect the outcomes of policy change. Our aim in this study was to support the development and interpretation of health economic models of the effects of changes to tobacco and alcohol policies by developing a conceptual understanding of the main components and mechanisms in the system that links policy change to outcomes. Methods Our study was based on a workshop from which we captured data on participant discussions on the joint tobacco–alcohol policy system. To inform these discussions, we prepared with a literature review and a survey of participants. Participants were academics and policy professionals who work in the United Kingdom. Data were analysed thematically to produce a description of the main components and mechanisms within the system. Results Of the people invited, 24 completed the survey (18 academic, 6 policy); 21 attended the workshop (16 academic, 5 policy). Our analysis identified eleven mechanisms through which individuals might modify the effects of a policy change, which include mechanisms that might lead to linked effects of policy change on tobacco and alcohol consumption. We identified ten mechanisms by which the tobacco and alcohol industries might modify the effects of policy changes, grouped into two categories: Reducing policy effectiveness; Enacting counter-measures. Finally, we identified eighteen research questions that indicate potential avenues for further work to understand the potential outcomes of policy change. Conclusions Model development should carefully consider the ways in which individuals and the tobacco and alcohol industries might modify the effects of policy change, and the extent to which this results in an unequal societal distribution of outcomes. Modelled evidence should then be interpreted in the light of the conceptual understanding of the system that the modelling necessarily simplifies in order to predict the outcomes of policy change.

scholarly journals Emerging challenges in the health systems of Kerala, India: qualitative analysis of literature reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manesh Muraleedharan ◽  
Alaka Omprakash Chandak
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Health System ◽  
Health Systems ◽  
Significant Proportion ◽  
Vital Statistics ◽  
The State ◽  
Future Research ◽  
Health Seeking ◽  
Content Type

PurposeThe substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.Design/methodology/approachA systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.FindingsChronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.Research limitations/implicationsThe present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.Originality/valueGiven the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

scholarly journals Verteilungsgerechtigkeit ohne Verteilungsgleichheit

1999 ◽  
Vol 21 (2) ◽  
Author(s):  
Thomas Schramme
Keyword(s):  
Distributive Justice ◽  
Good Life ◽  
Equality Of Opportunity ◽  
Alternative Approaches ◽  
Equal Respect ◽  
Formal Justice ◽  
The Ideal

AbstractAlternative approaches in the discussion of distributive justice differ in their answers to the question „equality of what“? In this essay I intend to ask instead ,why equality?" The article rejects several arguments in favour of distributive equality, mainly on the grounds that they confuse two different kinds of justice, namely ,formal’ justice (equal respect) and distributive justice. The ideal of distributive equality is based on comparisons but equal respect does not necessarily involve relational considerations. Subsequently I will consider equality of opportunity which appears on first sight to be the most promising account. However, I will point out that this approach is not convincing as an attempt to give everyone the chance to live a good life. Finally I will submit that only a theory of absolute needs is adequate.

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