Ch. 7 + 8 combined (resource allocation, public health)

what is public health?

healthcare that deals with anything impacting the health of populations that can be addressed via collective/gov. action. Decision makers are usually a dept. of the gov deciding on a policy impacting many ppl

What is a rival good?

A good that, when consumed, affects the availability of it to others ex: an organ transplant

What is an excludable good?

A good that it is possible to prevent people who have not paid for access to it from consuming it. Ex: access to info on the effectiveness of a new drug

what is a collective action problem?

The failure of a group of individuals from achieving or contributing to a result that everyone values. Ex: refusing organ donation, blood donation, vaccination

what does it mean to be a free rider?

When someone benefits off of others without contributing to that good themselves. Ex: being a non organ donor and receiving an organ transplant

What is an "opt-out" system?

People opt-out of being an organ donor. Donating is the default, and one has to register to not donate.

what are harm reduction programs?

programs aimed at reducing harmful effects from unhealthy behaviors. Not designed to stop the behaviors, but to deal with the effects. ex: methadone programs, needle exchange, supervised injection sites

what are the social determinants of health?

social + economic conditions in which ppl are born, grow up in, live, work, age etc. that impact ppl's health

What does Glannon argue in respect to free-riding and organ donation?

Argues to switch from "opt-in" systems to "opt-out" systems to increase organ donation and reduce free riding, and improve collective action where people take steps to increase the organ supply. Argues that morally one cannot receive an organ if they refuse to donate.

What does Small in regard to addiction harm reduction programs?

Argues addiction is a healthcare matter, not one of criminal justice. The context of drug use creates harm, need to respect personhood of those with addictions. That gov. and policy should not stand in the way of evidence-based healthcare.

What does Daniels argue in respect to unjust health inequalities?

Inequalities are unjust when they reflect unfair social inequalities. Argues for Rawls theory of justice: society must protect fair equality of opportunity (everyone has access to basic health resources). Democratic, balanced dec. making should be used in respect to deciding what is unjust and what resources are needed.

What are positive rights?

Rights that require others (ex: state/healthcare system) to provide goods, services, conditions needed for health.

ex: vaccinations, clean water, harm reduction programs

What are negative rights? 

Rights that require others not to interfere with your actions, choices/body integrity. Ex: right to refuse medical treatment, government must not arbitrarily restrict freedom, privacy

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.