Health policy in a new key: setting democratic priorities.
Health policy in the United States is entering an era in which explicitly value-based allocation decisions require direct attention. Policies concerning access to care, financing, and utilization management will necessarily have redistributive effects. For these policies to command social legitimacy and political support, some consensus will have to emerge around the values and ideals justifying these policies. This article addresses the problems of conceptual clarification and democratic process raised by the prospect of an explicitly value-based allocation policy. It offers a conceptual matrix distinguishing the scope of the issue of allocation in health care. Drawing on the activities of community health decisions projects in several states, it also offers suggestions about building a participatory and educational process at the grassroots level that might lead to a democratic consensus suitable for guiding policy choice.
Jennings
B
B
The Hastings Center, 255 Elm Road, Briarcliff Manor, NY 10510, USA.
D003256:Community Participation; D003709:Democracy; D036262:Empirical Research; D026689:Ethical Analysis; D006291:Health Policy; D006292:Health Priorities / Q000191:economics / Q000941:ethics*; D006801:Humans; D009922:Oregon; D011639:Public Opinion; D040841:Resource Allocation / Q000191:economics / Q000941:ethics* / Q000600:supply & distribution; D012935:Social Justice; D012945:Social Values; D012959:Socioeconomic Factors; D014481:United States