Ethics and Allocation: The Foundations of American Health Care Policy

Award Year:
Ruth Faden, G. Madison Powers
Ethical Dilemmas and Resource Allocation
Few authors have looked critically at both the moral foundations and conceptual underpinnings of welfare economics upon which analytic techniques in health care policy are based. This study examines the values and assumptions underlying alternative models of health care allocation cost-benefit, cost-effectiveness, and cost-utility and their application to health care policy. It addresses the implications for social justice associated with these methods and the need for practical guidelines in advance of their widespread utilization. The underlying assumptions of rational decision and social choice theory that connect the two in the context of health policy are also explored. Results reveal the moral tradeoffs entailed in choosing different methods for allocating resources in the context of decisions about eligibility, coverage, and reimbursement. The investigators' work provides greater understanding of these methods so that policymakers can choose among them with greater awareness of the ethical implications of their choices.