Equitable Distribution Of Health Care Research Articles

Sanctioning risky life-styles: Attitudes toward solidarity or equitable distribution of health care

Rising costs of medical care and increasing knowledge about behavior-related health risks favor the use of the equity principle in health care allocation. This paper deals with attitudes to the question of whether or not one's payments should be contingent upon the risks one takes. From an explorative analysis of arguments espoused by letter writers from a Dutch health magazine, it becomes apparent that equity plays a major role in the respondents' views of the distribution of health care facilities. Next, the role of attribution in adopting attitudes toward risky life-styles is studied on the basis of a survey using a representative sample of Dutch households. Beliefs about the individual ability to influence health have no effect on risk solidarity, whereas beliefs about the proper amount of effort to avoid health risks do have an effect.

Medical ethics needs a third dimension.

McCarthy, former chairman of a National Health Service area health authority, responds to an article by T.A.H. English, "What price excellence?," in the same issue of the Journal of Medical Ethics. Unlike English, she believes that Great Britain's present system for resource allocation has not achieved an equitable distribution of health care for the disadvantaged. She argues that English's emphasis on high technology care and on professional excellence reflects the physician's traditional ethic of obligation only to the individual patient. McCarthy asserts that this two-dimentisional ethic must be supplemented by a concern for society as a whole.