Equality, Explicitness, Severity, and Rigidity: The Oregon Plan Evaluated From a Scandinavian Perspective  

Oleh:

Hansson, Lars F. ; Ole, Frithjof Norheim ; Ruyter, Knut W.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Medicine and Philosophy vol. 19 no. 4 (Aug. 1994), page 343-366.
Topik: Equality; Fairness; One tier System; Prioritization; Severity of Disease; Rigidity

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: MM80.3 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

This article is an attempt to evaluate the Oregon plan from the perspective of a Scandinavian national health care system. The Nordic welfare states are marked by a strong emphasis on equality. As an example of an egalitarian system we present the Norwegian health care model in part one. In part two, the arguments in favor of a one tier system in Norway are presented and compared to Oregon’s two tier system. Although we argue, in part three, that a comparison of the degree of explicitness in the prioritization process shows that Norway system has some attractive elements that may function as an important corrective. In part four we present the Norwegian Guildelines for priority-setting and discuss the weight assigned to the severity of disease criterion. It is argued that exclusion of information about the severity of disease partly explains the counterintuitive ranking of treatment-condition pairs in Oregon’s initial method based on the principle of health maximization. A normative analysis of the conflicting norms of efficiency and equality result is called for. The final part of the paper is devoted to the problem of rigidity. Henry J. Aaron has argued that the Oregon system is insensitive to inter-individual variations within ech diagnosis-treatment pair. This objection is a serve one, since the system might end up treating patients unfairly on the individual level. To overcome this problem of rigidity.

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