Vertical Equity in Health Care Resource Allocation

This paper introduces this mini-series on vertical equity in health care. It reflects on the fact that by and large equity policies in health care have failed and that there is a need for positive discrimination to promote equity better in future. This positive discrimination is examined under the heading of 'vertical equity'. The paper considers Varian's notion of 'envy' as a basis for equity in health care but concludes that this is not a helpful route to go down. Better it would seem to pursue the idea from Sen of 'freedoms' and 'communitarian claims' (as raised previously by this author). While it is argued that procedural justice is to be preferred in the longer run as a basis for equity there are gains in adopting a short run goal of promoting distributive justice. Some preliminary evidence is presented on the weighting of health gains to reflect such vertical equity concerns.