Equal treatment for equal need is not enough — positive discrimination for disadvantaged groups is also required
With the “reform” of Medicare on the political agenda, it is timely to reflect on the objectives of fairness and equity that are key goals of our national health scheme. These objectives include both “horizontal equity”, or equal treatment for equal need, and “vertical equity”, which involves appropriately different treatment for those with different needs.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Blewett N. Minister for Health, Second Reading Speech, Health Legislation Amendment Bill 1983. House of Representatives Debates, 6 September 1983. http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22chamber%2Fhansardr%2F1983-09-06%2F0071%22 (accessed Mar 2015).
- 2. Council of Australian Governments. Closing the gap in Indigenous disadvantage. https://www.coag.gov.au/closing_the_gap_in_indigenous_disadvantage (accessed Nov 2014).
- 3. Rural and Regional Health Australia, Australian Government Department of Health. Patient assisted travel schemes. http://www.ruralhealthaustralia.gov.au/internet/rha/publishing.nsf/Content/Patient_Assisted_Travel_Schemes (accessed Nov 2014).
- 4. McKie J, Richardson J. The rule of rescue. Soc Sci Med 2003; 56: 2407-2419.
- 5. Australian Government Department of Health. Healthy Kids and Get Set 4 Life. http://www.health.gov.au/internet/main/publishing.nsf/Content/Healthy_Kids_Check (accessed Nov 2014).
- 6. Carr D; National Health Service Commissioning Board. Equality analysis: functions of the NHS Commissioning Board Special Health Authority. Redditch: NHS England, 2012. http://www.england.nhs.uk/wp-content/uploads/2012/02/NHSCBA-02-2012-9-Equality-Analysis-Final.pdf (accessed Nov 2014).
- 7. Hayman N. Improving Aboriginal and Torres Strait Islander people's access to the Pharmaceutical Benefits Scheme. Aust Prescr 2011; 34: 38-40.
- 8. Australian Government Department of Human Services. Medicare. Closing the Gap — PBS Co-payment Measure. http://www.humanservices.gov.au/health-professionals/services/pbs-closing-the-gap-co-payment-measure (accessed Mar 2015).
- 9. Richardson J, Sinha K, Iezzi A, Maxwell A. Maximising health versus sharing: measuring preferences for the allocation of the health budget. Soc Sci Med 2012; 75: 1351-1361.
- 10. Richardson J, Iezzi A. How important is severity for the evaluation of health services: new evidence using the Relative Social Willingness to Pay Instrument. Research Paper 2014 (88). Melbourne: Centre for Health Economics, Monash University, 2014. http://www.buseco.monash.edu.au/centres/che/pubs/researchpaper88.pdf (accessed Nov 2014).
- 11. Williams A, Tsuchiya A, Dolan P. Eliciting equity–efficiency trade-offs in health. In: Smith PC, Ginnelly L, Sculpher M, editors. Health policy and economics: opportunities and challenges. Maidenhead, UK: Open University Press and McGraw-Hill Education, 2005: 64-87.
- 12. Dolan P, Tsuchiya A. Determining the parameters in a social welfare function using stated preference data: an application to health. Appl Econ 2011; 43: 2241-2250.
- 13. Richardson J, Iezzi A, Sinha K, et al. An instrument for measuring the relative social willingness to pay for health state improvement. Health Econ 2014; 23: 792-805.
- 14. Richardson J. The effects of consumer co-payments in medical care, National Health Strategy Background Paper No. 5. Canberra: Australian Society Publishing, 1991.
- 15. Ong KS, Kelaher M, Anderson I, Carter R. A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population. Int J Equity Health 2009; 8: 34.
- 16. Australian Institute of Health and Welfare. The health and welfare of Australia's Aboriginal and Torres Strait Islander people: an overview 2011. Canberra: AIHW, 2011. (AIHW Cat. No. IHW 42.) http://www.aihw.gov.au/indigenous-observatory/health-and-welfare (accessed Nov 2014).
No relevant disclosures.