A more recent version of these Yernier Mind The Gap notes – written by Oxford students – is available here.
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Yernier - Mind the Gap!
There is a complexity in health care - it is three values coming into play as an inconsistent triad: o Butler: Three services available - cheap, quick and reliable. Can have any two, but not the third
? If it's cheap and quick it won't be reliable
? If it's reliable and cheap, it won't be quick
? And if it's quick and reliable, it won't be cheap o In healthcare, the three seem to be:
? Economic efficiency
? Decent quality care o Here, it also seems to be that we can have any two but not all three.
? If we want to provide comprehensive and qualitative care that is economically efficient, i.e. that promotes the public interest in a costeffective way,
it is likely that we enter into a health care system that offers such care only to those who can afford it. This raises objections based on considerations of justice.
? If, on the contrary, we want to provide decent-quality care on the basis of people's need rather than their ability to pay, it might turn out that the system is not efficient.
? And if we want to provide care equally to all those who need it, while preserving efficiency, the package might be very limited and of low quality. Essentially, the central question is the following: how best to square the proverbial welfare circle?
o What is scarcity?
? Quite a lot of problems that all contemporary health care systems face originate from scarcity of health care resources
Scarcity means that we do not have sufficient resources, and that there are limits to our technology and our management skills in producing enough to meet the existing demand.
Consequently, it implies that not all ofour own or society's goals can be realised at the same time; o that it is necessary to make choices as to how to use and allocate scarce goods and services; and thus, that we must trade off various goods against others.
? There are two aspects to scarcity
The external aspect, or opportunity cost - that is, the loss of something you might otherwise have had o E.g. losing an evening with a nice dinner in favour of writing an academic paper o The loss is the enjoyment you would have derived from the dinner o The external aspect refers to scarcity as a natural condition of limited resources (such as time, money, attention, et cetera).
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