Fair Enough? Inviting Inequities in State Health Benefits
Jennifer Prah Ruger
Yale School of Public Health, the Yale School of Medicine, the Yale University Graduate School of Arts and Sciences, and Yale Law School
New England Journal of Medicine, February 8, 2012; DOI 10.1056/NEJMp1200751.
Available online at: http://bit.ly/znBMdI
“……Those who object to the uniform-standards solution will counter that it idealistically and naively seeks, as measures of fairness, the same health outcomes and the same amounts of care for everyone. In fact, however, it is based on the principle of proportionality — the notion that similar cases should be treated similarly and different cases differently, in proportion to their differences. Medical cases in which the health needs are the same are deemed alike; those in which the health needs are different are considered unalike.
… The principle of equal access … would call for differential provision of health care resources to achieve the same desired outcome for both patients — giving each what he or she needs to reach a medically determined level of functional health.
… There is no perfect health care system. But setting a goal of equal access to high-quality, evidence-based care would be a step in the right direction. Unceasing effort to standardize comprehensive health coverage and reach a gold standard of care is essential to attaining this goal….”
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