Ch. 7 Delivery of Health Care and Resource Allocation

What is macroallocation?

Considerations of how much of resources should go into healthcare. Occurs at a societal level. Ex: How much $ to hospitals vs education

What is mesoallocation?

Considerations of what areas of healthcare should get what proportion of the resources available to healthcare. Occurs at an institutional level

Ex: how much $ allocated to the ER vs pediatric care

What is microallocation?

Considerations of which patients should receive healthcare when not all can. Involves triage to assign urgency to decide order of treatment in respect to scarce resources.

Ex: a mother with young children vs a middle aged bachelor

What is an egalitarian society?

Everyone is equally valuable, society has an obligation to provide them with basic resources for a good life. There is an obligation to provide not all the healthcare needed, but a decent minimum.

What is a libertarian society?

Seeks to maximize freedom, believes in a free market. The right to anything one justly aquires and the right to enter into just agreements. Ex: paying money in exchange for healthcare.

What is a liberal society?

combines egilitarian and libertarian to create a 2-tier system. Provides healthcare as a communal resource, while allowing for a private tier for advanced care for those who can afford it.

What is the egalitarian argument against the liberal view of healthcare delivery?

Argues that a private tier for purchase would deteriorate the quality of care in the public tier, creating a divide between the rich and the poor.

What does Dworkin argue in respect to a prudent insurance test?

That basic medical care should cover what a prudent person would reasonably purchase to insure themselves for. In the case of a free market, no special medical needs, and limited $ to spend.

What is the rescue principle?

That society is obliged to provide all the resources to save a life

What does Hope argue in respect to the rescue principle?

It undermines fair and just treatment by valuing actual vs statistical lives, argues in allocating fewer resources for emergency + acute care, and more for preventative care = to save more lives in the long run

What are 5 consideration for the complex criteria of microallocation?

1). how much will the pt benefit? 2). does the pt have dependents? 3). past/future contributions to society 4). pt age 5). is the pt responsible for their illness?

What is age based rationing?

Should we prioritize care for the elderly and deprioritize care for younger populations?

What is luck egalitarianism?

The view that individuals are responsible for the consequences if they are a result of their voluntary choices. Ex: smoking, drinking, overeating etc.

What does Rescher argue in respect to ELT?

That selection processes must be transparent and morally defensible. Argues for a 2-stage selection using eligibility + ethical + practical criteria, with random selection as the final determining factor.