Health, health expenditures, and equity

Abstract

Abstract What motivates studies dealing with the interpersonal (or interfamily, interhousehold, interclass) distribution of income, wealth, health, and so on? They seem usually to have been undertaken so as to enable judgements to be made (by either their authors or their readers) of the ‘fairness’, ‘justice’, or ‘equity’ of such distributions with respect to some benchmark distribution (which need not, of course, be an equal distribution). It seems reasonable to ask two fundamental questions to do with their motivation. The first is: ‘What is the ethical theory that underlies the study?’ This issue is examined elsewhere in the present volume by Alan Williams (Chapter 16) and I shall not examine it further here other than to note that, because there is more than one ‘ideology’ serving as justi¬ fication (e.g., utilitarian, desert-based, Rawlsian) it would be in general helpful (although no doubt rather complicated) if studies were to be so conducted as to enable equity judgements to be made from a variety of viewpoints or ideologies (rather than that only of the authors-if they have one). When one is confident of there being a consensus amongst the trageted readership, this desideratum is less compelling, of course. The second question is: ‘Why study the distribution of whatever entity it is that has been studied?’ In the case of the present volume, there are two entities-health care expenditures on the one hand, and health care payments on the other. In this section I shall explore some reasons why it may be interesting to examine the distribution of health expenditures. That of payments will be discussed subsequently.

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