The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy

Document Type : Debate

Author

School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

Abstract

In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation.

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References

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History

  • Receive Date: 11 August 2017
  • Revise Date: 27 September 2017
  • Accept Date: 02 October 2017
  • First Publish Date: 01 April 2018

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