Question

Analyze the issue of equity in the context of the American beliefs and values using concepts of market and social justice for the rationing of services.

1. Present your thesis statement based on your research using a full sentence.

2. Using a proper outline format, discuss 2 primary topics/issues,  based on supported content from your research. Single words/short phrases are not enough description; use full sentences.

3. Place journal references

Answer 1

Rationing

It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied.

Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing.

Rationing can be applied in 4 levels:

1. health care policy- makers,

2. health care managers,

3. health care providers,

4. patients.

Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles.

Health care rationing literature is large, complex, and diverse. Critical interpretive synthesis enables researchers to critically synthesize a diverse body of evidences and studies in a given field and generate theories. While conventional systematic review aims to test theories through searching for, appraising, and synthesizing the findings of the primary studies (aggregative syntheses) in a fixed procedure of predefined sequence, critical interpretive synthesis aims to generate a theory by including many different forms of evidence (Interpretive syntheses) through iterative, dynamic, interactive, and recursive processes of question formulation, searching for, data extraction, critique, and synthesis.

Equity

In the United States, the tenets of egalitarianism, seen properly as the very "moral economy" upon which the ideology of healthcare distribution is anchored, hold fast to the notion that only when legal rights are equalized among all citizens can "equity of access," here-to healthcare resources-be achieved. In fact, this is seen as the moral economy upon which the system was originally erected. Whether society is moving slowly, albeit almost imperceptively, from a state of materialism grounded in "economic values" to one of "post materialism where other values such as ethics are as significant" is speculative at best. If ethics have relevance, however, it is to be found within the principle of distributive justice which seeks a fair way to distribute scarce commodities.

A foundational debate about distributive justice is how to navigate the conflicting impulses to maximize efficiency (making decisions so as to produce the most good with the least expenditure), equity (treating individuals equally), and prioritarian conceptions of justice (favoring the worst off). Therefore, three approaches to allocating scarce resources grounded in these radically different philosophical notions of justice: utilitarianism, egalitarianism, and prioritarianism.

References

1. Justice and Access to Health Care.First published Mon Sep 29, 2008; substantive revision Fri Oct 20, 2017.

2. The Catholic University of America, Columbus School of Law CUA Law Scholarship Repository.

3. Social values and health systems in health policy and systems research: a mixed-method systematic review and evidence map. Eleanor Whyle, Jill Olivier. Health Policy and Planning, Volume 35, Issue 6, July 2020, Pages 735–751, https://doi.org/10.1093/heapol/czaa038.

4. The Ethics and Reality of Rationing in Medicine. Leslie P. Scheunemann, MD, MPH and Douglas B. White, MD.

5. Rationing in health systems: A critical review. Iman Keliddar, 1 Ali Mohammad Mosadeghrad, 2 ,* and Mehdi Jafari–Sirizi 3.