ECON 440 Lecture Notes - Lecture 2: Canada Health Act, Amartya Sen, Externality
13 Jun 2018
School
Department
Course
Professor
Sum of individual productivity is the wealth of society
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Productivity spillovers
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Health
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Fiscal (publicly financed health care systems)
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Externalities
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How, and why, does health enter into the Social Welfare Function?
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The presence of health in society
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The distribution of health in society
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Addressing health care needs
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Ethical concerns about:
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Altruism is a preference - an altruistic person gets utility from seeing another person be healthy or receive health care
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Equity or social justice concerns derive from principles concerning what a person ought to have as a right
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Why does Society Value Health?
Justice
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Need Evaluating Equity
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Canada Health Act
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Outline
Positive: what is a factual statement
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Usually points towards policies; positive analysis are used to back policies
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Normative: what should be, an opinion based on values and judgment
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A judgement about what goals are desirable
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Choosing a method to attain those goals
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Policymaking involves
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Economic tools can be very useful in answering positive questions
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Normative questions are informed by ethical principles, philosophy, and value systems
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Positive, Normative, and Economics
Health is a critical component of well-being, a basis for a person's ability to function and to achieve things in life
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Ill health is somewhat random and beyond individual's control: people should not suffer excessively bc of chance or fate
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Therefore, justice dictates that those in ill health should receive treatment on the basis of need, not on ability to pay (like
most other commodities)
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1: Justice and Health
Care little for distribution
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Utilitarian: maximize the sum of all individual utilities in society; accepts harm to a few in exchange for benefit for many
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Libertarian: right to life, right to possessions; concern with minimum standard of health for all
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Identify social justice principles before we know what our social position would be
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Departures from equality are allowed only if they benefit those worst off
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Rawls (1971): social choices must be fair; process more important than the chosen distribution
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Different Theories of Social Justice that Might Apply to Health Care
Of access to health care?
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Of allocation according to need?
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Of health?
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Capabilities: not important that everyone achieve the same level of health but that everyone have the same
opportunity to do so
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Amartya Sen (1992) argues that justice demands equality in the distribution of something;
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Equality of Capabilities
If because of poor decisions --> no right to claim help
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If because of bad luck --> right to claim help
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Is the individual in need as the result of choices or decisions they have made, or because of bad luck?
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Mounk (2017) highlights the increased focus on responsibility in considering what a state owes its citizens
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Justice becomes being about rewarding the deserving (responsible) and punishing the underserving (irresponsible)
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The larger purposes our political institutions are designed to serve
Mounk (2017) argues for greater focus on:
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Responsibility as Accountability
Lecture 2 - Why Health?: Ethics and Equity
Tuesday, January 23, 2018
5:56 PM
ECON 440 Page 1
Document Summary
Sum of individual productivity is the wealth of society. Altruism is a preference - an altruistic person gets utility from seeing another person be healthy or receive health care. Equity or social justice concerns derive from principles concerning what a person ought to have as a right. Normative: what should be, an opinion based on values and judgment. Usually points towards policies; positive analysis are used to back policies. Economic tools can be very useful in answering positive questions. Normative questions are informed by ethical principles, philosophy, and value systems. Health is a critical component of well-being, a basis for a person"s ability to function and to achieve things in life. Ill health is somewhat random and beyond individual"s control: people should not suffer excessively bc of chance or fate. Therefore, justice dictates that those in ill health should receive treatment on the basis of need, not on ability to pay (like most other commodities)
