Hostname: page-component-7c8c6479df-7qhmt Total loading time: 0 Render date: 2024-03-29T13:59:29.727Z Has data issue: false hasContentIssue false

Priority setting in health care: from arbitrariness to societal values

Published online by Cambridge University Press:  18 July 2012

PHILIPPE BATIFOULIER*
Affiliation:
EconomiX, University Paris Ouest Nanterre La Défense, France
LOUISE BRADDOCK*
Affiliation:
Girton College, University of Cambridge, UK
JOHN LATSIS*
Affiliation:
Henley Business School, University of Reading, UK

Abstract:

This paper develops an account of the normative basis of priority setting in health care as combining the values which a given society holds for the common good of its members, with the universal provided by a principle of common humanity. We discuss national differences in health basket in Europe and argue that health care decision-making in complex social and moral frameworks is best thought of as anchored in such a principle by drawing on the philosophy of need. We show that health care needs are ethically ‘thick’ needs whose psychological and social construction can best be understood in terms of David Wiggins's notion of vital need: a person's need is vital when failure to meet it leads to their harm and suffering. The moral dimension of priority setting which operates across different societies’ health care systems is located in the demands both of and on any society to avoid harm to its members.

Type
Research Article
Copyright
Copyright © Millennium Economics Ltd 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Batifoulier, P., Latsis, J., and Merchiers, J. (2009), ‘The Philosophy of Need and the Normative Foundations of Health Policy’, Revue de Philosophie Économique, 10 (1): 79101.Google Scholar
Brouwer, W., Culyer, A., van Exel, J., and Rutten, F. (2008), ‘Welfarism vs Extra-WelfarismJournal of Health Economics, 27: 325338.Google Scholar
Busse, R., Schreyogg, J., and Smith, P. (2008), ‘Variability I, Healthcare Treatment Costs Amongst Nine EU Countries – Results from the Healthbasket Project’, Health Economics, 17: S1S8.Google Scholar
Cookson, R. and Dolan, P. (2005), ‘Principles of Justice in Health Care Rationing’, Journal of Medical Ethics, 26: 323329.Google Scholar
Culyer, A. (1995), ‘Need: The Idea Won't Do – But We Still Need It’, Social Sciences and Medicine, 40 (6): 727730.Google Scholar
Davis, J. B. (ed.), (2001), The Social Economics of Health Care, London: Routledge.Google Scholar
Dolan, P. and Tsuchiya, A. (2005), ‘Health Priorities and Public Preferences: The Relative Importance of Past Health Experience and Future Health Prospects’, Journal of Health Economics, 24: 703714.Google Scholar
Dormont, B., Grignon, M., and Huber, H. (2006), ‘Health Expenditure Growth: Reassessing the Threat of Ageing’, Health Economics, 15: 947963.Google Scholar
Evans, R. (1974), ‘Supplier-Induced Demand: Some Empirical Evidence and Implications’, in Perlman, M. (ed.), The Economics of Health and Medical Care, London: Macmillan, pp. 162173.Google Scholar
Green, C. J. (2009), ‘Investigating Public Preferences on Severity of Health as a Relevant Condition for Setting Healthcare Priorities’, Social Science & Medicine, 68: 22472255.Google Scholar
Ham, C. (1997), ‘Priority Setting in Health Care: Learning from International Experience’, Health Policy, 42: 4966.Google Scholar
Hamilton, L. (2003), The Political Philosophy of Needs, Cambridge: Cambridge University Press.Google Scholar
Hasman, A., Hope, T., and Osterdal, P. (2006), ‘Health Care Need: Three Interpretations’, Journal of Applied Philosophy, 2: 143156.Google Scholar
Hodgson, G. (2008), ‘An Institutional and Evolutionary Perspective on Health Economics’, Cambridge Journal of Economics, 32: 235256.Google Scholar
Hodgson, G. (2009), ‘Towards an Alternative Economics of Health Care’, Health Economics, Policy and Law, 4: 99114.Google Scholar
Hurley, J. (2000), ‘An Overview of the Normative Economics of the Health Sector’, in Culyer, A. and Newhouse, J. (eds.), Handbook of health economics, vol. 1A, The Netherlands: North Holland, pp. 56118.Google Scholar
Jan, S. (1998), ‘Holistic Approach to the Economic Evaluation of Health Programmes Using Institutionalist Methodology’, Social Science and Medicine, 47: 15651572.CrossRefGoogle Scholar
Korica, M. and Molloy, E. (2010), ‘Making Sense of Professional Identities: Stories of Medical Professionals and New Technologies’, Human Relations, 63 (12): 18791901.CrossRefGoogle Scholar
Lancsar, E., Wildman, J., Donaldson, C., Ryan, M., and Baker, R. (2011), ‘Deriving Distributional Weights for QALYs Through Discrete Choice Experiments’, Journal of Health Economics, 30: 466478.Google Scholar
Leonard, C., Stordeur, S., and Robertfroid, D. (2009), ‘Association Between Physician Density and Health Care Consumption: A Systematic Review of the Evidence’, Health Policy, 9: 121134.Google Scholar
Maarse, H. and Paulus, A. (2003), ‘Has Solidarity Survived? A Comparative Analysis of the Effect of Social Health Insurance Reform in Four European Countries’, Journal of Health Politics, Policy and Law, 28: 585614.Google Scholar
Massé, R. (2005), ‘Les Fondements Ethiques et Anthropologiques d'une Participation du Public en Santé Publique’, Ethique Publique, 7: 107124.Google Scholar
McIntyre, D. and Mooney, G. (2007), The Economics of Health Equity, Cambridge: Cambridge University Press.CrossRefGoogle Scholar
McKie, J. and Richardson, J. (2000), ‘The Rule of Rescue’, Social Science & Medicine, 56: 24072419.Google Scholar
McMaster, R. (2002), ‘A Socio-Institutionalist Critique of the 1990s’ Reforms of the UK's National Health Service’, Review of Social Economy, 60 (3): 403433.Google Scholar
McMaster, R. (2007), ‘On the Need for Heterodox Health Economics’, Post-Autistic Economics Review, 41: 922.Google Scholar
Menzel, P. (1999), ‘How Should What Economists Call “Social Values” be Measured?’,Journal of Ethics, 3: 249273.Google Scholar
Mooney, G. (1998), ‘Communitarian Claims as an Ethical Basis for Allocating Health Care Resources’, Social Sciences and Medicine, 47 (9): 11711180.Google Scholar
Mooney, G. (2001), ‘Communitarianism and Health Economics’, in Davis, (ed.), The Social Economics of Health Care, London: Routledge, pp. 4059.Google Scholar
Mooney, G. (2005), ‘Communitarian Claims and Community Capabilities: Furthering Priority Setting?’, Social Sciences and Medicine, 60: 247255.Google Scholar
Mooney, G. (2009), ‘Is it Time for Health Economists to Rethink Equity and Access?’, Health Economics, Policy and Law, 4 (2): 209221.Google Scholar
Mooney, G. (2010), Challenging Health Economics, Oxford: Oxford University Press.Google Scholar
Nguyen-Kim, L., Or, Z., Paris, V., and Sermet, C. (2005), ‘The Politics of Drug Reimbursement in England, France and Germany’, IRDES Health Economics Letter, 99: 14.Google Scholar
Nord, E., Pinto, L., Richardson, J., Menzel, P., and Ubel, P. (1999), ‘Incorporating Societal Concerns for Fairness in Numerical Valuations of Health Programmes’, Health Economics, 8: 2539.Google Scholar
Olsen, J. A., Richardson, J., Dolan, P., and Menzel, P. (2003), ‘ The Moral Relevance of Personal Characteristics in Setting Health Care’, Social Science & Medicine, 57: 11631172.Google Scholar
Peacock, S., Mitton, C., Bate, A., McCoy, B., and Donaldson, C. (2009), ‘Overcoming Barriers to Priority Setting Using Interdisciplinary Methods’, Health Policy, 92: 124132.Google Scholar
Robinson, R. (1999), ‘Limits to Rationality: Economics, Economists and Priority Setting’, Health Policy, 49: 1326.Google Scholar
Sabik, L. and Lie, R. (2008), ‘Priority Setting in Health Care: Lessons from the Experiences of Eight Countries’, International Journal for Equity in Health, 7: 113.Google Scholar
Saltman, R. (2002), ‘Regulating Incentives: The Past and Present Role of the State in Health Care Systems’, Social Science and Medicine, 54: 16771694.Google Scholar
Sassi, F. (2003), ‘Setting Priorities for the Evaluation of Health Interventions: When Theory does not Meet Practice’, Health Policy, 63: 141154.Google Scholar
Schreyogg, J., Stargardt, T., Velasco-Garrido, M., and Busse, R. (2005), ‘Defining the Health Benefit Basket in Nine European Countries’, European Journal of Health Economics, 1: 210.Google Scholar
Sen, A. K. (1977), ‘Rational Fools: A Critique of the Behavioural Foundations of Economic Theory’, Philosophy and Public Affairs, 6 (4): 317–44.Google Scholar
Sen, A. K. (1991), On Ethics and Economics, Oxford: Wiley-Blackwell.Google Scholar
Shah, K. (2009), ‘Severity of Illness and Priority Setting in Healthcare: A Review of the Literature’, Health Policy, 93: 7784.Google Scholar
Stolk, E., Pickee, S., Ament, A., and Busschbach, J. (2005), ‘Equity in Health Care Prioritization: An Empirical Inquiry into Social Value’, Health Policy, 74: 343355.Google Scholar
The European Journal of Health Economics (2005), ‘Special Issue Healthbasket’, 6, Supplement: 2–23.Google Scholar
Wiggins, D. (1987), ‘Claims of Need’, in Wiggins, D. (ed.), Needs, Values, Truth: Essays In the Philosophy of Value, Oxford: Basil Blackwell, pp. 157.Google Scholar
Williams, A. (1997), ‘Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument’, Health Economics, 6 (2): 117132.Google Scholar
Williams, B. (1973), ‘The Idea of Equality’ in Williams, B. (ed.) Problems of the Self, Cambridge: Cambridge University Press, pp. 230249.Google Scholar
Williams, B. (1981)[1974–1975], ‘The Truth in Relativism’, in Williams, B. (ed.) Moral Luck, Cambridge: Cambridge University Press, pp. 132143.Google Scholar
Williams, B. (1995)[1983], ‘What does Intuitionism Imply?’, in Williams, B. (ed.), Making Sense of Humanity, Cambridge: Cambridge University Press, pp. 182191.Google Scholar
Wiseman, V., Mooney, G., Berry, G., and Tang, K. (2003), ‘Involving the General Public in Priority Setting Experiences from Australia’, Social Science & Medicine, 56: 10011012.Google Scholar
Wynand, P. and Van de Ven, M. (1996), ‘Market-Oriented Health Care Reforms: Trends and Future Options’, Social Science and Medicine, 43: 655666.Google Scholar