Abstract
Allocating on the basis of need is a distinguishing principle in publicly funded health care systems. Resources ought to be directed to patients, or the health program, where the need is considered greatest. In Sweden support of this principle can be found in health care legislation. Today however some domains of what appear to be health care needs are excluded from the responsibilities of the publicly funded health care system. Corrections of eye disorders known as refractive errors is one such domain. In this article the moral legitimacy of this exception is explored. Individuals with refractive errors need spectacles, contact lenses or refractive surgery to do all kinds of thing, including participating in everyday activities, managing certain jobs, and accomplishing various goals in life. The relief of correctable visual impairments fits well into the category of what we typically consider a health care need. The study of refractive errors does belong to the field of medical science, interventions to correct such errors can be performed by medical means, and the skills of registered health care professionals are required when it comes to correcting refractive error. As visual impairments caused by other conditions than refractive errors are treated and funded within the public health care system in Sweden this is an inconsistency that needs to be addressed.
Highlights
Society is responsible for ensuring the equitable provision of basic welfare of its citizens, and it discharges this responsibility in part through public health care [16]
One thing that must be established is the severity, or magnitude, of the need. We address this issue in the “Refractive Errors in a Prioritization Setting” section, where we argue that while the population in need of refractive corrections is anything but homogenous, for at least some of these individuals their condition could be quite severe and does constitute a considerable health care need, one which is at least deserving of public funding as the alleviation of conditions that are considered deserving of public funding based on the severity of the need
How can we assess the needs of individuals with refractive errors in a standardized fashion that allows comparisons to be made with other health care needs? We need an assessment tool that allows for comparisons, and preferentially some kind of grading, between various health states
Summary
Society is responsible for ensuring the equitable provision of basic welfare of its citizens, and it discharges this responsibility in part through public health care [16]. One thing that must be established is the severity, or magnitude, of the need We address this issue in the “Refractive Errors in a Prioritization Setting” section, where we argue that while the population in need of refractive corrections is anything but homogenous, for at least some of these individuals their condition could be quite severe and does constitute a considerable health care need, one which is at least deserving of public funding as the alleviation of conditions that are considered deserving of public funding based on the severity of the need. Does poor visual acuity caused by a refractive error constitute a health care need? The need for refractive correction exhibits a number of characteristics of what we would in other contexts consider to be health care needs While this does not settle the issue of whether, at the end of the day, it ought to be viewed this way, it does, at least, place the burden of argument on anyone who would object to this classification.
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