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Health Care Analysis

, Volume 8, Issue 3, pp 217–233 | Cite as

Resource Allocation within Australian Indigenous Communities: A Program for Implementing Vertical Equity

  • Virginia WisemanEmail author
  • Stephen Jan
Article

Abstract

Given the significant disparities in health and health related disadvantage between Aboriginal andnon-Aboriginal Australians, the application of somenotion of equity has a role to play in the formulationof policy with respect to Aboriginal health. Aboriginal andTorres Strait Islander has been abbreviated to Aboriginal. There has been considerable debate in Australia as to what the principles of equity should be. This paper discussesthe relevance of the principle of vertical equity (theunequal, but equitable, treatment of unequals) toAboriginal health funding. In particular, the paperadvocates pursuing procedural justice as the basis forvertical equity where the focus is on the fairness ofhow things are done rather than on the distribution ofoutcomes per se (i.e. distributive justice).Particular attention is paid to how the principle ofvertical equity might be handled at a practical level.Details of the approach used in a number of Australianindigenous communities are discussed. It is concludedthat there are strong arguments for pursuingprocedural justice under vertical equity particularlywhen there are cultural differences in the ways healthis defined and when there is importance attached toindigenous involvement in the health care decisionmaking process.

Aboriginal health health care decision-making procedural justice resource allocation vertical equity 

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References

  1. Anderson, I. (1994) Powers of Health. Arena, June-July, 32–36.Google Scholar
  2. Australian Bureau of Statistics & Australian Institute of Health andWelfare (1997) The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, ABS Cat. no. 4704.0, AIHW Cat. no. IHW2. Canberra: ABS.Google Scholar
  3. Australian Bureau of Statistics (1994) National Aboriginal and Torres Strait Islander Survey, Social Atlas, Cat. no. 4155.0. Canberra: AGPS.Google Scholar
  4. Australian Bureau of Statistics (1991) 1989-90 National Health Survey, Summary of Results, Cat. no. 4364.0. Canberra: AGPS.Google Scholar
  5. Australian Institute of Health and Welfare (1996) Australia's Health 1996. Canberra: AGPS.Google Scholar
  6. Berkowitz, L. (1975) A Survey of Social Psychology. Illinois: The Dryden Press.Google Scholar
  7. Brady, M. (1995) Who Defines Health? Implications of Differing Definitions on Discourse and Practice in Aboriginal Health, 1995. In G. Robinson (ed.) Aboriginal Health: Social and Cultural Transitions. Proceedings of a Conference at the Northern Territory University Darwin, September. Darwin: NTU Press.Google Scholar
  8. Cohen, D. (1994) Marginal Analysis in Practice: An Alternative to Needs Assessment for Contracting Health Care. British Medical Journal 309, 781–784.Google Scholar
  9. Davey J. and Leeder S. (1992) The Cost of Migraine: More Than Just a Headache? Pharmacoeconomics 2, 5–7.Google Scholar
  10. Dolan, P. (1998) TheMeasurement of Individual Utility and Social Welfare. Journal of Health Economics 17, 39–52.Google Scholar
  11. Donaldson, C. (1995) Economics, Public Health and Health Care Purchasing: Reinventing the Wheel? Health Policy 33, 79–90.Google Scholar
  12. Drummond, M. (1992) Cost of Illness Studies. A Major Headache? Pharmacoeconomics 2, 1–4.Google Scholar
  13. Gafni, A. and Birch, S. (1991) Equity Considerations in Utility-Based Measures of Health Outcomes in Economic Appraisals: An Adjustment Algorithm. Journal of Health Economics 10, 329–342.Google Scholar
  14. Hawe, P. (1994) Capturing the Meaning of ‘Community’ in Community Intervention Evaluation: Some Contributions from Community Psychology. Health Promotion International 9, 199–210.Google Scholar
  15. Hunter, E. (1993) Aboriginal Health and History. Power and Prejudice in Remote Australia. Cambridge: Cambridge University Press.Google Scholar
  16. Kunitz, S. (1994) Disease and Social Diversity. The European Impact on the Health of Non-Europeans. New York: Oxford University Press.Google Scholar
  17. McLennan, W. and Madden, R. (1997) The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples. Australian Bureau of Statistics, Cat. no. 4704.0. Canberra: ABS.Google Scholar
  18. Mooney G. (2000) Vertical Equity in Health Care Resource Allocation. Health Care Analysis, this issue.Google Scholar
  19. 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. Report to the South Australian Health Commission, Adelaide.Google Scholar
  20. Mooney, G., Jan, S. and Wiseman, V. (1998) Equity and Aboriginal and Torres Strait Islander Health Services. Report to the Office of Aboriginal and Torres Strait Islander Health Services, Department of Health and Family Services, Canberra.Google Scholar
  21. Mooney, G. (1998) ‘Communitarian Claims’ as an Ethical Basis for Allocating Health Care Resources. Social Science and Medicine 47, 1171–1180.Google Scholar
  22. Mooney, G. and Jan, S. (1997) Vertical Equity: Weighting Outcomes? Or Establishing Procedures? Health Policy 39, 79–88.Google Scholar
  23. Mooney, G. (1997) Setting the Directions. Report to the South Australian Health Commission, SPHERe, Department of Public Health and Community Medicine, University of Sydney.Google Scholar
  24. Mooney, G. (1996) And Now for Vertical Equity? Some Concerns Arising from Aboriginal Health in Australia. Health Economics 5, 99–103.Google Scholar
  25. Mooney, G. and Creese, A. (1993) Priority Setting for Health Service Efficiency: The Role of Measurement of Burden of Illness. In: D. Jamison, W. Mosely, A. Measham and J. Bobadilla (eds.), Disease Control Priorities in Developing Countries. New York: Oxford University Press.Google Scholar
  26. Mooney, G., Russell, E. and Weir, R. (1986) Choices for Health Care: A Practical Introduction to the Economics of Health Provision, 2nd Edition. London: Macmillan.Google Scholar
  27. National Aboriginal Health Strategy Working Party. (1989) Report of the National Health Strategy Working Party. AGPS, Canberra.Google Scholar
  28. Nord, E. (1994) The QALY: A Measure of Social Value Rather than Individual Utility. Health Economics 3, 89–93.Google Scholar
  29. North, D. (1991) Institutions. Journal of Economics Perspectives 5, 97–112.Google Scholar
  30. NSW Health Department. (1996) Implementation of the Economic Statement for Health. Structural and Funding Policy Branch, Policy Development Division, Sydney.Google Scholar
  31. Palmer, G. and Short, S. (1994) Health Care and Public Policy. An Australian Analysis. Melbourne: MacMillan Education Australia.Google Scholar
  32. Ratnaike, R. Collings, M. Dorward, S. and Brogan, R. (1987) Diarrhoeal Disease in an Aboriginal Community. European Journal of Epidemiology 3, 312–315.Google Scholar
  33. Rice, T. (1998) The Economics of Health Reconsidered. Chicago: Health Administration.Google Scholar
  34. Saggers, S. and Gray, D. (1991) Aboriginal Health and Society. NSW: Allen and Unwin.Google Scholar
  35. Scott, A., Donaldson, C. and Scott, S. (1999) Programme Budgeting and Marginal Analysis: Pragmatism and Policy. Journal of Health Services Research and Policy 4, 1–2.Google Scholar
  36. Sen, A. (1987) On Ethics and Economics. Oxford: Blackwell.Google Scholar
  37. Sheill, A., Gerard, K. and Donaldson, C. (1987) Cost of Illness Studies: An Aid to Decision-Making? Health Policy 8, 317–323.Google Scholar
  38. Twaddle, A. and Hessler, R. (1977) A Sociology of Health. Saint Louis: Mosby Company.Google Scholar
  39. Wagstaff, A., van Doorslaer, E. and Paci, P. (1991a) On the Measurement of Horizontal Inequity in the Delivery of Health Care. Journal Of Health Economics 10, 169–205.Google Scholar
  40. Wagstaff, A., van Doorslaer, E. and Paci, P. (1991b) Equity in the Finance and Delivery of Health Care: Some Tentative Cross-Country Comparisons. In A. McGuire, P. Mayhew and Ken (eds.) Providing Health Care: The Economics of Alternative Systems of Finance and Delivery. Oxford and New York: Oxford University Press.Google Scholar
  41. Wagstaff, A. and van Doorslaer, E. (1992) Equity in The Finance of Health Care: Some International Comparisons. Journal of Health Economics 11, 361–387.Google Scholar
  42. Walters, V. (1993) Stress, Anxiety and Depression: Women's Accounts of Their Health Problems. Social Science and Medicine 36, 393–402.Google Scholar
  43. Williams, A. (1997) Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument. Health Economics 6, 117–132.Google Scholar
  44. Williams, A. (1996) QALYs and Ethics: A Health Economist's Perspective. Social Science and Medicine 43, 1795–1804.Google Scholar
  45. Wiseman, V. (1999) Culture, Self-Rated Health and Resource Allocation Decision-Making. Health Care Analysis 7, 207–223.Google Scholar
  46. Wiseman, V. and Mooney, G. (1998) Burden of Illness Estimates for Priority Setting: A Debate Revisited. Health Policy 43, 243–351.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  1. 1.SPHERe – Social and Public Health Economics Research Group, Department of Public Health and Community MedicineUniversity of SydneyAustralia
  2. 2.SPHERe – Social and Public Health Economics Research Group, Department of Public Health and Community MedicineUniversity of SydneyAustralia

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