International Journal of Health Policy and Management

International Journal of Health Policy and Management

Tradeoff Negotiation: The Importance of Getting in the Game; Comment on “Swiss-CHAT: Citizens Discuss Priorities for Swiss Health Insurance Coverage”

Document Type : Commentary

Author
Ann Mongoven
Markkula Center for Applied Ethics, Santa Clara University, Santa Clara, CA, USA
10.15171/ijhpm.2018.86
Abstract
Swiss-CHAT’s playful approach to public rationing can be considered in terms of deliberative process design as well as in terms of health policy. The process’ forced negotiation of trade-offs exposed unexamined driving questions, and challenged prevalent presumptions about health care demand and about conditions of public reasoning that enable transparent rationing. While the experiment provided grounds for optimism that public deliberation can contribute to the design of fair insurance service-packages, it also left unanswered questions. What are the ethical and policy implications of non-consensuses? What is the presumed relationship between process and justice of outcome?

Highlights

 

Watch the Video Summary here.

Keywords
Deliberation
Healthcare Rationing
Health Policy
Health Insurance
Tradeoff Negotiation
Subjects

 

 

 

  1. Hurst SA, Schindler M, Goold SD, Danis M. Swiss-CHAT: citizens discuss priorities for Swiss health insurance coverage. Int J Health Policy Manag. 2018;7(8):746-754. doi:10.15171/ijhpm.2018.15
  2. Young IM. Impartiality and the Civic Public: Some Implications of Feminist Critiques of Moral and Political Theory. Praxis International. 1985;5(4):381-401.
  3. Rawls J. The Idea of Public Reason Revisited. Univ Chic Law Rev. 1997;64(3):765-807. doi:10.2307/1600311
  4. Mongoven A, Lake D, Platt J, Kardia S. Negotiating deliberative ideals in theory and practice: a case study in “hybrid design.” Journal of Public Deliberation. 2016;12(1):art 1.
  5. Beekman V, Brom FWA. Ethical tools to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. J Agric Environ Ethics. 2007;20(1):3-12. doi:10.1007/s10806-006-9024-7
  6. Ryan M, Scott DA, Reeves C, et al. Eliciting public preferences for healthcare: a systematic review of techniques. Health Technol Assess. 2001;5(5):1-186.
  7. Fishkin JS. Consulting the public through deliberative polling. J Policy Anal Manage. 2003;22(1):128-133. doi:10.1002/pam.10101
  8. Fleck LM. Just Caring: Health Care Rationing and Democratic Deliberation. New York: Oxford University Press; 2009.
  9. Williams MH, Frankel SJ. The myth of infinite demand. Crit Public Health. 1993;4(1):13-18. doi:10.1080/09581599308406877
  10. Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-1367. doi:10.1007/s11606-012-2077-6
  11. Fishbanks: a renewable resource management simulation. https://mitsloan.mit.edu/LearningEdge/simulations/fishbanks/Pages/fish-banks.aspx.
International Journal of Health Policy and Management
Volume 7, Issue 12
December 2018
Pages 1148-1150

  • Received Date 03 June 2018
  • Revised Date 29 August 2018
  • Accepted Date 29 August 2018
  • First Published Date 01 December 2018
  • Published Date 01 December 2018