Health Care Analysis

, Volume 8, Issue 3, pp 203–215 | Cite as

Vertical Equity in Health Care Resource Allocation

  • Gavin Mooney


This paper introduces this mini-series on verticalequity in health care. It reflects on the fact that byand large equity policies in health care have failedand that there is a need for positive discriminationto promote equity better in future. This positivediscrimination is examined under the heading of`vertical equity'.The paper considers Varian's notion of `envy' as abasis for equity in health care but concludes thatthis is not a helpful route to go down. Better itwould seem to pursue the idea from Sen of `freedoms'and `communitarian claims' (as raised previously bythis author). While it is argued that proceduraljustice is to be preferred in the longer run as abasis for equity there are gains in adopting a shortrun goal of promoting distributive justice. Somepreliminary evidence is presented on the weighting ofhealth gains to reflect such vertical equityconcerns.

distributive justice envy health care procedural justice resource allocation vertical equity 


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  1. Avineri, S. and de Shalit, S. (1992) Introduction. In S. Avineri and S. de Shalit (eds.) Communitarianism and Individualism. Oxford: Oxford University Press.Google Scholar
  2. Baumol, W. (1986) Superfairness. Cambridge, MA: MIT Press.Google Scholar
  3. Broome, J. (1991) Weighing Goods. Oxford: Blackwell.Google Scholar
  4. Buchanan, A. (1995) Privatization and Just Health Care. Bioethics 9, 220–239.Google Scholar
  5. Campbell, R. (1984) The New Science: Self-Esteem Psychology. Lanham, MD: University Press of America.Google Scholar
  6. Culyer, A. (1990) Commodities, Characteristics of Commodities, Characteristics of People, Utilities and the Quality of Life, In S. Baldwin, C. Godfrey and C. Propper (eds.) Quality of Life: Perspectives and Policies. London: RoutledgeGoogle Scholar
  7. Culyer, A. and Wagstaff, A. (1993) Equity and Equality in Health and Health Care. Journal of Health Economics 12, 431–457.Google Scholar
  8. Deeble, J., Mathers, C., Smith, L., Goss, J., Webb, R. and Smith, V. (1998) Expenditures on Health Services for Aboriginal and Torres Strait Islander People. Public Affairs, Commonwealth Department of Health and Family Services, Canberra.Google Scholar
  9. van Doorslaer, E., Wagstaff, A. and Rutten, F. (1993) Equity in the Finance and Delivery of Health Care. Oxford: Oxford University Press.Google Scholar
  10. Kaplan, H. (1975) Self-Attitudes and Deviant Behaviour. California: Pacific Palisades.Google Scholar
  11. Korsgaard, C. (1993) Commentary on Cohen and Sen. In M. Nussbaum and A. Sen (eds.) The Quality of Life. Oxford: Clarendon Press.Google Scholar
  12. Kunitz, S. (1994) Disease and Social Diversity. The European Impact on the Health of Non-Europeans. Oxford: Oxford University Press.Google Scholar
  13. McIntyre, D. (1997) Input Paper on Health for the South African Poverty and Inequality Report. Health Economics Unit, Cape Town: University of Capetown.Google Scholar
  14. Mooney, G. (1998) ‘Communitarian Claims’ as an Ethical Basis for Allocating Health Care Resources. Social Science and Medicine 47, 1171–1180.Google Scholar
  15. Mooney, G. (2000) The Need to Build Community Autonomy in Public Health. Australian and New Zealand Journal of Public Health 24, 2–3.Google Scholar
  16. Mooney, G. and Jan, S. (1997) Vertical Equity: Weighing Outcomes? Or Establishing Procedures? Health Policy 39, 79–87.Google Scholar
  17. Mooney, G. and Wiseman, V. (1998) A ‘Constitution’ for Health Services. Journal of Health Services Research and Policy 4, 195–196.Google Scholar
  18. Mooney, G., Jan, S., Ryan, M., Bruggemann, K. and Alexander, K. (1999) What the Community Prefers, What It Values, What Health Care It Wants. A Survey of South Australians. SPHERe, Sydney: University of Sydney.Google Scholar
  19. Nord, E. (1994) The QALY: a Measure of Social Value Rather than Individual Utility. Health Economics 3, 89–93.Google Scholar
  20. Nagel, T. (1986) The View from Nowhere. Oxford: Oxford University Press.Google Scholar
  21. Olsen, J. (1997) Theories of Justice and Their Implications for Priority Setting in Health Care. Journal of Health Economics 16, 22–30.Google Scholar
  22. Rawls, J. (1972) A Theory of Justice. Oxford: Oxford University PressGoogle Scholar
  23. Schokkaert, E. (1992) The Economics of Distributive Justice, Welfare and Freedom. In K. Scherer (ed.) Justice: Interdisciplinary Perspectives. Cambridge: Cambridge University Press.Google Scholar
  24. Sen, A. (1982) Choice, Welfare and Measurement. Oxford: Basil Blackwell.Google Scholar
  25. Sen, A. (1984) Rights as Goals, The Austin Lecture, 6 April 1984 (Quoted in Schokkaert op.cit.).Google Scholar
  26. Sen, A. (1985) Commodities and Capabilities. Amsterdam: North Holland.Google Scholar
  27. Sen, A. (1987) The Standard of Living. Cambridge: Cambridge University Press.Google Scholar
  28. Sen, A. (1992) Inequality Re-examined. Oxford: Clarendon Press.Google Scholar
  29. Titmuss, R. (1970) The Gift Relationship. London: Allen and Unwin.Google Scholar
  30. Walzer, M, (1983) Spheres of Justice. Oxford: Blackwell.Google Scholar
  31. Williams, A. (1997) Intergenerational Equity: an Exploration of the ‘Fair Innings’ Argument. Health Economics 6, 117–132.Google Scholar
  32. Wiseman, V. and Jan, S. (2000) Resource Allocation within Australian Indigenous Communities: A Program for Implementing Vertical Equity. Health Care Analysis, this issue.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Gavin Mooney
    • 1
  1. 1.Social and Public Health Economics Research Group (SPHERe), Department of Public Health and Community MedicineUniversity of SydneyAustralia

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