Amy Gutmann
- Published in print:
- 1995
- Published Online:
- November 2003
- ISBN:
- 9780198280088
- eISBN:
- 9780191599927
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0198280084.003.0006
- Subject:
- Political Science, Political Theory
Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts ...
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Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts between multiple meanings of goods, which require adjudication in accordance with moral considerations that cut across distributive spheres. Drawing on the several meanings of productive employment and medical care in contemporary USA, she concludes that justice is complex, but not specific to distinct spheres.Less
Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts between multiple meanings of goods, which require adjudication in accordance with moral considerations that cut across distributive spheres. Drawing on the several meanings of productive employment and medical care in contemporary USA, she concludes that justice is complex, but not specific to distinct spheres.
Mark Schlesinger
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195170665
- eISBN:
- 9780199850204
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195170665.003.0024
- Subject:
- Political Science, American Politics
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes ...
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This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.Less
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.
Deborah Stone
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195170665
- eISBN:
- 9780199850204
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195170665.003.0022
- Subject:
- Political Science, American Politics
This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter ...
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This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter suggests that market ideology is the biggest obstacle to health-care equity. The U.S. health-care system is designed to produce disparities, since it allocates medical care primarily by market criteria rather than by medical need. Market principles generate racial and ethnic disparities, and allow racism to continue under cover of economic justifications. The chapter argues that the nation will not be able to ameliorate racial and ethnic disparities until political leaders are willing to face up to the consequences of their devotion to the pluralistic ideals in medicine.Less
This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter suggests that market ideology is the biggest obstacle to health-care equity. The U.S. health-care system is designed to produce disparities, since it allocates medical care primarily by market criteria rather than by medical need. Market principles generate racial and ethnic disparities, and allow racism to continue under cover of economic justifications. The chapter argues that the nation will not be able to ameliorate racial and ethnic disparities until political leaders are willing to face up to the consequences of their devotion to the pluralistic ideals in medicine.
Gunnar Almgren
- Published in print:
- 2017
- Published Online:
- January 2019
- ISBN:
- 9780231170130
- eISBN:
- 9780231543316
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231170130.003.0006
- Subject:
- Political Science, Public Policy
The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield ...
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The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.Less
The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.
