Abstract
This essay seeks to characterise the essential features of an equitable health care system in terms of the classical Aristotelian concepts of horizontal and vertical equity, the common (but ill-defined) language of "need" and the economic notion of cost-effectiveness as a prelude to identifying some of the more important issues of value that policy-makers will have to decide for themselves; the characteristics of health (and what determines it) that can cause policy to be ineffective (or have undesired consequences); the information base that is required to support a policy directed at securing greater equity, and the kinds of research (theoretical and empirical) that are needed to underpin such a policy.
Key Words: Health care systems • equity • horizontal equity • vertical equity • cost-effectiveness
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Selected References
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- Harris J. QALYfying the value of life. J Med Ethics. 1987 Sep;13(3):117–123. doi: 10.1136/jme.13.3.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McPherson K., Wennberg J. E., Hovind O. B., Clifford P. Small-area variations in the use of common surgical procedures: an international comparison of New England, England, and Norway. N Engl J Med. 1982 Nov 18;307(21):1310–1314. doi: 10.1056/NEJM198211183072104. [DOI] [PubMed] [Google Scholar]
- Mooney G. H. Equity in health care: confronting the confusion. Eff Health Care. 1983 Dec;1(4):179–185. [PubMed] [Google Scholar]
- Stanley J. M. The Appleton Consensus: suggested international guidelines for decisions to forego medical treatment. J Med Ethics. 1989 Sep;15(3):129–136. doi: 10.1136/jme.15.3.129. [DOI] [PMC free article] [PubMed] [Google Scholar]