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

Document Type : Commentary


Markkula Center for Applied Ethics, Santa Clara University, Santa Clara, CA, USA


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?



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Main Subjects




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Volume 7, Issue 12
December 2018
Pages 1148-1150
  • Receive Date: 03 June 2018
  • Revise Date: 29 August 2018
  • Accept Date: 29 August 2018
  • First Publish Date: 01 December 2018