Equity In Allocation Research Articles

Equity, fairness, and the development of a sustainability ethos

Estimates made just before the 21 st century indicate that, by the year 2100, Earth may have between 10 and 11 billion people—not quite double the 6 billion population count reached in October 1999. Sustainable use of the planet requires that human needs be met without impairing the integrity of the planet's ecological life support system. This objective will almost certainly require equity and fairness in resource allocation among members of the human species and with natural sys- tems upon which humans depend. For the first time in history, humans have the power to create seri- ous disequilibrium in natural systems at a global level. Nature is not vengeful, but it is opportunistic; new 'equilibrium conditions' are likely to be far less favorable to humans than present conditions. To prevent disequilibrium, a new ethos or set of guiding beliefs regarding human society's relationship with natural systems is essential. The best descriptor of the new ethos is eco-ethics (www.eeiu.org) guided by ethical science and implemented by compassionate, reasoned environmental politics. ESEP, the publication organ of the Eco-Ethics International Union, should be a powerful force in developing the necessary integration of science and value systems while maintaning the integrity of both.

Spending and financing in health care: situation and trends

Being knowledgeable about national health expenditures and sources of financing is essential for decision-making. This awareness also makes it possible to evaluate the equity of allocation and the efficiency of utilization of these resources. Changes in financing have been a substantial component of health sector reform in the Americas. The goal has shifted from merely one of financial sustainability to simultaneously seeking equitable access to quality services. In this article the Pan American Health Organization (PAHO) presents a proposal for analyzing and designing a policy on health financing. The aim of the policy is to identify the mix of financing mechanisms most likely to simultaneously produce financial sustainability, equity, access, and efficiency. The PAHO proposal combines traditional mechanisms for generating resources (public funds from taxes, as well as private health insurance, national health insurance, and user fees) with complementary subsidy mechanisms for vulnerable groups. Health financing strategies ought to explicitly consider the financing both of care for individuals and of health interventions for the general public good, for which public financing is the most equitable and efficient approach.

Decentralization of health systems in Latin America.

Decentralization is often a major part of health reform policies. However, there have been few attempts to comparatively study the degree of decentralization and the effects of decentralization on equity of allocations to health, so we do not know how best to implement this reform. This article uses an innovative comparative analysis of the "decision space" that was allowed to local municipalities in the health reforms of Bolivia and Chile, two countries that have had several years of experience in implementing decentralization. The studies found that relatively little decision space was allowed to local authorities over key functions of health care systems. The studies also found that central authorities often reduce the decision space in order to direct more resources to health or to restrict local choice over human resources issues. The studies found that more equitable allocations of health funding were achieved through a common equalization fund for the municipalities in Chile and by forcing the assignment to health of a specific percentage of the central government transfers to municipalities in Bolivia.

Re-educating Namibia: The Early Years of Radical Education Reform, 1990-1995

Following independence the Namibian government saw primary education reform as a principal means of investing in human capital to promote socioeconomic development. This paper analyzes the efforts made during the first five years of the reform program. While emphasis on structural change learner-centered education and universality provided strong foundations for a democratic educational system a difficult medium of instruction policy and insufficient attention to gender equity delayed a comprehensive transformation. This analysis calls for greater educator participation in implementing the pedagogical approach altering the language-of-instruction policy greater gender equity in resource allocation and greater attention to sex and AIDS education. (authors)

Commons Problems, Collective Action and Efficiency

The article explores three interrelated questions related to institutional design: the roles of states and communities in creating and maintaining institutions designed to resolve commons problems arising from the use of natural resource systems; the substantive content of such institutions with respect to allocative efficiency and equity; and effects on allocative efficiency of the interactive relationship between, on the one hand, institutions designed specifically to inhibit free-riding, and on the other, broader social arrangements such as marriage customs or membership in a community, which create expectations of stable, ongoing relations between parties across a number of issue areas.

Differing site conditions risks: a FIDIC/engineering and construction contract comparison

A new edition of the FIDIC Red Book is under discussion. It is an issue whether this edition should be based on the current edition or there should be a complete break with tradition in favour of a contract based on a new philosophy such as that of the NEC, which is reported to be used in many countries in circumstances in which the Red Book would otherwise have been used. This article compares the two contracts on the way they deal with site conditions issues. The comparison is on equity and clarity in risk allocation, adequacy of contractual procedures for dealing with unforeseeable conditions encountered, effectiveness of contractual machinery for dispute resolution, and compliance with reported new developments in successful contractual practices in underground construction. Studies highlighting the recurring frequency of claims for unforeseen ground conditions suggest a need for such particular attention to this aspect of construction. Although a desire for some equity in risk sharing is discernible in both contracts, there is room for improvement in the clarity of both contracts. Each contract has commendable features which are not present in the other. However, a better approach involves a combination of these features with full compliance of the reported modern developments in successful contracting practices.

Differing site conditions risks: a FIDIC/engineering and construction contract comparison

A new edition of the FIDIC Red Book is under discussion. It is an issue whether this edition should be based on the current edition or there should be a complete break with tradition in favour of a contract based on a new philosophy such as that of the NEC, which is reported to be used in many countries in circumstances in which the Red Book would otherwise have been used. This article compares the two contracts on the way they deal with site conditions issues. The comparison is on equity and clarity in risk allocation, adequacy of contractual procedures for dealing with unforeseeable conditions encountered, effectiveness of contractual machinery for dispute resolution, and compliance with reported new developments in successful contractual practices in underground construction. Studies highlighting the recurring frequency of claims for unforeseen ground conditions suggest a need for such particular attention to this aspect of construction. Although a desire for some equity in risk sharing is discernible in both contracts, there is room for improvement in the clarity of both contracts. Each contract has commendable features which are not present in the other. However, a better approach involves a combination of these features with full compliance of the reported modern developments in successful contracting practices.

Equity and the Order of Selection Mandate

The order of selection mandate, the cornerstone of the federal policy initiative to serve individuals with the most severe disabilities in the state-federal vocational rehabilitation (VR) program, is examined from the perspective of equity. The order of selection mandate is founded on the fair opportunity rule, which asserts that individuals who experience the most severe disadvantages resulting from disability have the greatest claim to available agency resources. Several challenges to the appropriate implementation of the order of selection mandate are identified. Also, difficulties in evaluating equity in program participation and agency resource allocation are discussed, and two standards for evaluation, consistency, and impartiality are proposed. Then, recent research on the quality of order of selection implementation in state-federal VR is reviewed, and recommendations to facilitate the equitable implementation of the mandate and to evaluate progress in meeting the goal of serving individuals with the most severe disabilities are proposed. Most importantly, standard, quantifiable data on VR program participants' severity of disability are needed to permit warranted conclusions about equity in order of selection implementation and evaluation.

Severity variations within DRGs: measurement of hospital effects by use of data on significant secondary diagnoses and procedures.

The Diagnosis Related Group classification has provided an excellent basis for enhancing the equity of resource allocation between public acute hospitals. However, it underestimates the higher levels of severity and consequent costliness of referral hospitals. This paper describes a practical way of measuring within-DRG variations in severity, which can be used to increase the precision of casemix-based funding. It involves the regression of length of stay against the numbers of significant diagnoses and procedures, and bence the prediction of additional justified costs. An example is given of its application to data from South Australian public hospitals.

INDICATIONS FOR AND TIMING OF LIVER TRANSPLANTATION

The tremendous success of OLT as a highly effective treatment for patients with end-stage liver disease has resulted in a rapid increase in the number of candidates for the procedure. Refinements in organ preservation, improvements in surgical technique and immunosuppression, and better postoperative management have contributed to improved survival rates. The discrepancy between the paucity of organs and the increasing numbers of potential recipients will continue to worsen until there are extraordinary breakthroughs in providing alternatives to human whole-organ livers, such as xenografts or cultured hepatocyte infusions. For now, the vast majority of patients with life-threatening liver disease are not likely to receive a liver graft. Thus, the issues of patient selection and timing of OLT have become even more relevant. Prompt referral to a transplant center is not only in the patient's best interest, but also it has been shown to be cost-effective. Over the last 30 years, it has become clear that hepatic malignancy, initially a common reason for OLT, should be an indication for transplantation only in highly selected individuals. The role of adjuvant chemotherapy needs to be defined, and proven treatment alternatives need to be developed. New antiviral agents may enable a large group of patients with chronic hepatitis B to be successfully transplanted, placing even greater demands on the already limited supply of donor livers. Hepatitis B appears to be species specific, and it is conceivable that xenotransplantation from a nonsusceptible donor species may confer protection to HBV reinfection, eliminating the problems of an inadequate donor supply. Until novel approaches, including xenotransplantation, gene therapy, or replacement of hepatic function by cultured hepatocyte infusions, become a widespread reality, future allocation policies may highlight outcome as well as urgency as a fundamental variable to determine if transplantation is reasonable. Survival rates have been shown to fall with advancing levels of urgency, resulting in a conflict between equity and efficacy in organ allocation. As waiting lists for liver transplantation continue to grow, it is becoming increasingly apparent that patients must be referred to a transplant center earlier in the course of liver disease.

Modeling water balance components in relation to field layout in lowland paddy fields. II: Model application

In a companion paper, the development of a water balance model to predict the changes in water balance components in relation to field layout in lowland paddy fields was outlined. In this study, the model was applied to a large irrigated area to assess and compare the water balance of intensive and extensive field layouts. The results show significant differences in water balance which are attributed to the layouts and water management practices. The field layouts influenced the equity of water allocation, effective rainfall, water use efficiencies and relative proportion of various water balance components. Eight indices are computed to evaluate the effects of layout under different land and hydrological conditions. Appropriate measurement scales for ranking the indices are proposed.

On the Relevance of John Rawls's Theory of Justice to Welfare Economics

Mainstream microeconomic theory makes some use of John Rawls's Theory of Justicein discussing welfare economics and social welfare functionals. While various elements of his approach are usually mentioned, his basic point is generally taken to be his difference principle (maximizing the welfare of the worst off individual) applied as a decision principle for evaluating the equity of resource allocation. To take the difference principle as the essence of Rawls's work is an error. The present paper reviews the basic argument of the Theory of Justice compares it with the use that economists make of it, and concludes that in a number of quite specific ways Rawls's ideas are misrepresented and misused by mainstream microeconomists.

Reward allocation in task-performing groups.

Three situational variables were varied to assess the relative weight given to equity and equality principles in reward allocations in task-performing groups:(a) the functional relation between individual and group performance (additive, conjunctive, or disjunctive), (b) the amount of variation among performances of individual members, and (c) the purpose of the allocation. In 2 studies, participants were asked to allocate rewards among 3 performers in a hypothetical situation; in a third study, participants actually performed a task and were asked to allocate rewards to themselves and the other group members. The 3 studies produced two strikingly similar results: (a) equity was given more weight relative to equality when input variation was small rather than large, and (b) the disjunctive relation, when the performance of one member was critical to group success, led to more equitable allocations than did the additive or conjunctive relation.

Equity Considerations in Economic and Policy Analysis

There is little doubt that equity considerations play some role in human decision making. This can be seen through statements that we are all created equal, or that we have equal This can also be seen through some of the transfer mechanisms that societies are willing to put in place for the benefits of the poor or the malnourished. In spite of this evidence, the role of equity in resource allocation remains poorly understood. Most economic analyses tend to focus on efficiency issues and avoid addressing distribution issues. As argued by Sen (1987, 1992), as long as human behavior is affected by equity considerations, it seems that economics could be made more productive by paying greater attention to welfare distribution. At the center of equity is whether and how to distinguish between people in terms of their needs, their abilities, their contributions, and their individual rights. People being different, at least some of their differences seem to be relevant to the economic evaluation of equity issues. At this point, it remains somewhat unclear how to approach such issues. The current debate about equity has been profoundly influenced by Rawls's Theory of Justice. Rawls's theory is based on the concept of justice as fairness.1 It relies on a so-called original where individuals do not yet know their exact position in society. Rawls suggests that a society is just if its current members would find the original fair. Rawls's views have been influential, yet controversial. Part of the debate comes in part from some antagonism between equity, and rights (e.g., Nozick). And private property rights are often seen as contributing to inequalities of wealth in modern society. The objective of this paper is to explore equity issues, with a special focus on interactions between efficiency, equity, and the role of information in resource allocation. In the next

Judging givers: Equity and scale in aid allocation

The paper proposes a ranking index to judge both the quality and quantity of aid given by donor nations. The quality of aid is restricted to a single dimension, viz., how well an aid giver's allocation conforms to the revealed need of aid recipients. Departing from previous work by McGillivray and White, aid is assumed to be additive to recipient incomes. The index satisfies the twin canons of horizontal and vertical equity and provides unbiased comparisons across all allocations. It also obviates the need to have separate and very likely conflicting rankings of donors by equity and scale of aid allocation.

Perceptions of equity and procedural preferences for water allocation decisions

Abstract The concepts of equity and procedural justice have greater significance as competition for water resources increases. In this study procedural preferences and attitudes towards equity in groundwater allocation were measured for residents of Perth, Western Australia. The most preferred procedure was arbitration. Moot and market‐driven allocation procedures were the least popular. Preferences for specific procedures were not modified by the degree of conflict in the allocation. Attitudes towards equity in water allocation revealed two factors: “egalitarianism”; and “proportionality.”; Most people supported an egalitarian view of water allocation. There was a significant positive correlation between support for egalitarianism and positive attitudes towards procedural justice. Positive attitudes towards proportionality were associated with a perception of greater conflict in allocation issues. Sub‐groups of individuals high on egalitarianism and proportionality were identified. Proportional individua...

Life‐Sustaining Technologies: Value Issues

This article examines life-extending technologies such as resuscitation, mechanical ventilation, antibiotics, dialysis, and artificial nutrition and hydration. It considers these technologies in terms of the value issues of (1) equity of access, (2) equity of allocation, (3) cost-effectiveness and appropriateness of use, (4) legal concerns, and (5) determination and control of the application of technology. How we resolve these issues tests our character as individuals and as a society--it plays a key role in determining who shall live and what kind of society we shall become.

The economics of higher education and tests of equity criteria in Turkey

Unequal opportunities are a fact of life in most societies. Imbalances exist in each society under all conceivable economic environments. To alleviate these imbalances, most governments tend to interfere in the market. In this respect Turkey is no exception. Thus, the government established the Turkish Higher Education Council in 1982 with the hope of improving educational resource allocation. This paper investigates the private costs of public higher education in Turkey. It also tests whether a structural cost difference exists between the universities in the three biggest cities of Turkey and the rest of the country's fifteen Universities. Does the highly subsidized Turkish Higher Education ensure equity of resource allocation? The findings show that, among the factors contributing to higher education, the number of faculty members has the lowest price elasticity of demand. In the case of assessing whether there are structural cost differences between the universities in developed and underdeveloped regions the findings show that imbalances between the two regions still exist.

Fairness in Book Fund Allocation

Efforts to improve book fund allocations have generally focused on developing better formulas, or models, that utilize quantitative measures to determine how the budget will be divided among various subjects. Librarians are attracted to the seemingly rational approach of formulas, but their potential to provide better allocations is limited by the environment in which allocation decisions are made in academic libraries. This environment is characterized by scarce resources, conflicting departmental goals, and a virtually infinite number of factors that affect the need for library resources. Each one of these considerations stimulates deep concern about the fairness and equity of allocations. Research on how recipients view their allocations and the process by which they are made offers insights that can help library administrators and collection developers to manage the allocation process more effectively.

Imperfect institutional innovation for irrigation management in Bangladesh

This paper discusses the nature and consequences of institutional innovation being pursued in recent years for the organization and management of minor irrigation in Bangladesh. The comparative analysis presented in this paper suggests that there are no significant variations of performance between the mainstream management institutions, except that tubewells under BRDB-Cooperative groups performed less well than others, nor are there any significant associations between major technical factors and irrigation performance (other than nominal pump capacity). What appears to be more important is that the economic institutions such as payment system for water is strongly associated with productivity and equity performance; sharecropping with water, which has emerged, or been popularized, with the privatization programme, has negative impact on productivity and skews benefits of irrigation towards pump owners and managers. It is concluded that so far imperfectly designed institutions, for example privatization of equipment, appear to have failed to give rise to greater technical and allocative efficiency or equity.