Understanding Health Inequalities and Justice

Amidst ongoing debate about health care reform, the need for informed analyses of U.S. health policy is greater than ever. The twelve original essays in this volume show that common public debates bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, the contributors illuminate the relationships between justice and health inequalities to complicate and enrich debates often dominated by simplistic narratives. Understanding Health Inequalities and Justice: New Conversations Across the Disciplines grounds key conceptual discussions in timely case studies and policy analyses that explore three overarching questions: (1) how do scholars approach relations between health inequalities and ideals of justice; (2) when do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice; and (3) how can diverse scholarly approaches contribute to better health policy. From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume combines the skills and sensibilities of diverse scholars to promote a richer understanding of health and justice and the successful paths to their realization.

1990 ◽  
Vol 16 (3) ◽  
pp. 327-380
Author(s):  
David A. Hyman

Tax exemption is an ancient, honorable and expensive tradition. Tax exemption for hospitals is all of these three, but it also places in sharp focus a fundamental problem with tax exemption in general. Organizations can retain their tax exemption while changing circumstances or expectations undermine the rationale that led to the exemption in the first place. Hospitals are perhaps the best example of this problem. The dramatic changes in the health care environment have eliminated most of the characteristics of a hospital that originally persuaded the citizenry to grant it an exemption. Hospitals have entered into competition with tax-paying businesses, and have increasingly behaved like competitive actors. Such conduct may well be beneficial, but it does not follow that tax exemption is appropriate. Rather than an undifferentiated subsidy, a shift to focused goals will provide charitable hospitals with the opportunity and incentive to “do the right thing.”


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