How to address resource allocation in health in a fair and just manner?
The right to healthcare is limited and there are conflicts of access or right to healthcare e.g. when it happens that two persons both need a donated kidney. There are limits in available resources.
1. scarcity of resources can be radical (not enough for everyone) or comparative (not enough to treat everyone now)
2. financial constraints (no money v unfair distribution)
3. increase supply and demand
- improved technology in treating more diseases (supply)
- innovations by pharmaceutical companies who need to generate profits (supply)
- people expect longer life (demand)
- nature of the treatment changes over time (supply)
4. macro-allocation: happens between government departments / hospitals
5. micro-allocation: happens between individual patients
6. global allocation
- equity: insufficient resources for medicines / staff
- responses: individual (moral duty to the country)
government (aid to citizens, any strings attached)
supplier (drug companies, moral obligations)
7. national allocation: some regions are more favoured over others?
socio-economic status affects access to healthcare?
8. need based analysis: decided by a range of people including medical professionals, managers, economists, politicians, public opinions, lobby groups, media
9. cost:benefit of treatment which aims at
- avoiding suffering
- prolonging life
- improving access to private healthcare
In UK, National Institute for Clinical Excellence (NICE) has the power to decide what treatments they would and would not prescribe.