Cohen Joshua, Burg Edwige
Tufts Center for the Study of Drug Development, Tufts University, 192 South St., Suite 550, Boston, MA 02111, USA.
J Med Philos. 2003 Jun;28(3):327-38. doi: 10.1076/jmep.28.3.327.14586.
Health care resource distribution is a subject of debate among health policy analysts, economists, and philosophers. In the United States, there is a widening gap between the more- and less-advantaged socioeconomic sub-populations in terms of both health care resource distribution and outcomes. Conventional wisdom suggests that there is a tradeoff, a zero-sum game, between efficiency and fairness in the distribution of health care resources. Promoting fairness in the distribution of health care resources and outcomes is not efficient in terms of maximization of a health outcome production function. On the other side of the coin, improving efficiency comes at the expense of fairness. Such conventional wisdom is supported in part by standard static Paretian welfare analysis. However, in this paper it is shown that in a dynamic setting in which there are efficiency gains in the health production function, fairness in distribution of health care resources can improve simultaneously.
医疗保健资源分配是卫生政策分析师、经济学家和哲学家之间争论的一个话题。在美国，在医疗保健资源分配和结果方面，社会经济状况较优和较差的亚人群之间的差距正在扩大。传统观点认为，在医疗保健资源分配中，效率与公平之间存在权衡，是一场零和博弈。从健康结果生产函数最大化的角度来看，促进医疗保健资源和结果分配的公平性是没有效率的。另一方面，提高效率是以牺牲公平为代价的。这种传统观点部分得到了标准静态帕累托福利分析的支持。然而，本文表明，在健康生产函数存在效率提升的动态环境中，医疗保健资源分配的公平性可以同时得到改善。
