Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage
- PMID: 26673330
- PMCID: PMC4629695
- DOI: 10.15171/ijhpm.2015.184
Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage
Abstract
This article discusses what ethicists have called "unacceptable trade-offs" in health policy choices related to universal health coverage (UHC). Since the fiscal space is constrained, trade-offs need to be made. But some trade-offs are unacceptable on the path to universal coverage. Unacceptable choices include, among other examples from low-income countries, to expand coverage for services with lower priority such as coronary bypass surgery before securing universal coverage for high-priority services such as skilled birth attendance and services for easily preventable or treatable fatal childhood diseases. Services of the latter kind include oral rehydration therapy for children with diarrhea and antibiotics for children with pneumonia. The article explains why such trade-offs are unfair and unacceptable even if political considerations may push in the opposite direction.
Keywords: Equity; Ethics; Health Policy; Rationing; Universal Healthcare.
© 2015 by Kerman University of Medical Sciences.
Comment in
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Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".Int J Health Policy Manag. 2016 Sep 1;5(9):557-559. doi: 10.15171/ijhpm.2016.61. Int J Health Policy Manag. 2016. PMID: 27694683 Free PMC article.
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Policy Choices for Progressive Realization of Universal Health Coverage Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".Int J Health Policy Manag. 2017 Feb 1;6(2):107-110. doi: 10.15171/ijhpm.2016.99. Int J Health Policy Manag. 2017. PMID: 28812786 Free PMC article.
References
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- World Health Organization (WHO). Making Fair Choices on the Path to Universal Health Coverage. Final Report of the WHO Consultative Group on Equity and Universal Health Coverage. Geneva: WHO; 2014. - PubMed
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- Rawls J. A Theory of Justice. Cambridge, MA: Harvard University Press; 1999.
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- Daniels N. Just Health: Meeting Health Needs Fairly. Cambridge: Cambridge University Press; 2008.
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