THRESHOLD CONSIDERATIONS IN FAIR ALLOCATION OF HEALTH RESOURCES: JUSTICE BEYOND SCARCITY

Application of egalitarian and prioritarian accounts of health resource allocation in low-income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that resul...

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Bibliographic Details
Main Author: Alvarez, Allen Andrew A. (Author)
Format: Electronic Article
Language:English
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Published: Wiley-Blackwell 2007
In: Bioethics
Year: 2007, Volume: 21, Issue: 8, Pages: 426-438
Further subjects:B Distributive Justice
B Sufficiency
B extreme scarcity
B threshold norm
B health resource allocation
B priority setting
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Summary:Application of egalitarian and prioritarian accounts of health resource allocation in low-income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that result from such allocation schemes. Insufficient health care and severe deprivation of health resources are difficult to accept even when justified by aggregative efficiency or legitimized by fair deliberative process in pursuing equality and priority oriented outcomes. I affirm the sufficientarian argument that, given extreme scarcity of public health resources in low-income countries, neither health status equality between populations nor priority for the worse off is normatively adequate. Nevertheless, the threshold norm alone need not be the sole consideration when a country's total health budget is extremely scarce. Threshold considerations are necessary in developing a theory of fair distribution of health resources that is sensitive to the lexically prior norm of sufficiency. Based on the intuition that shares must not be taken away from those who barely achieve a minimal level of health, I argue that assessments based on standards of minimal physical/mental health must be developed to evaluate the sufficiency of the total resources of health systems in low-income countries prior to pursuing equality, priority, and efficiency based resource allocation. I also begin to examine how threshold sensitive health resource assessment could be used in the Philippines.
ISSN:1467-8519
Contains:Enthalten in: Bioethics
Persistent identifiers:DOI: 10.1111/j.1467-8519.2007.00580.x