Multicultural health care: reconciling universalism and particularism.

Abstract

One of the issues of concern in multicultural health care is the degree to which one universal (or mainstream) service can meet the needs of all groups and the extent to which specialist (or ethno-specific) services are required to meet the needs of particular groups. In order to advance debate on this issue, multiculturalism is examined against concepts of identity, equality, bureaucracy and participation. While the appeal of universal healthcare services is that they appear to deliver equal health care to all, they in fact systematically advantage those whose values most closely fit with the dominant social norms. Although ethnic-specific services may overcome this problem, in that they enable 'tailor-made' care, it is unlikely that they would be able to meet all of the health needs of all people from ethnic minorities, especially in locations where numbers are low. Ethnic minority participation in the processes of the health system is proposed as a way for the universal health system to reconcile the need to treat people equally (universalism), but in accordance with their unique and different needs (particularism).