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Income-based equity weights in healthcare planning and policy
  1. Anders Herlitz1,2
  1. l Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden
  2. 2 Department of Philosophy, Rutgers University—the State University of New Jersey, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Anders Herlitz, Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Box 100, Gothenburg SE-405 30, Sweden; andersherlitz{at}gmail.com

Abstract

Recent research indicates that there is a gap in life expectancy between the rich and the poor. This raises the question: should we on egalitarian grounds use income-based equity weights when we assess benefits of alternative benevolent interventions, so that health benefits to the poor count for more? This article provides three egalitarian arguments for using income-based equity weights under certain circumstances. If income inequality correlates with inequality in health, we have reason to use income-based equity weights on the ground that health inequality is bad. If income inequality correlates with inequality in opportunity for health, we have reason to use such weights on the ground that inequality in opportunity for health is bad. If income inequality correlates with inequality in well-being, income-based equity weights should be used to mitigate inequality in well-being. Three different ways in which to construe income-based equity weights are introduced and discussed. They can be based on relative income inequality, on income rankings and on capped absolute income. The article does not defend any of these types of weighting schemes, but argues that in order to settle which of these types of weighting scheme to choose, more empirical research is needed.

  • Allocation of Health Care Resources
  • Political Philosophy
  • Health Economics
  • Health Care Economics
  • Distributive Justice

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Footnotes

  • Funding Forte, the Swedish Council for Health, Working Life and Welfare (2014-2724).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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