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Value congruence in health care priority setting: social values, institutions and decisions in three countries

Published online by Cambridge University Press:  01 December 2014

Claudia Landwehr*
Affiliation:
Department of Political Science, Johannes Gutenberg-University Mainz, Mainz, Germany
Dorothea Klinnert
Affiliation:
Department of Political Science, Johannes Gutenberg-University Mainz, Mainz, Germany
*
*Correspondence to: Prof. Claudia Landwehr, Department of Political Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany. Email: landwehr@politik.uni-mainz.de

Abstract

Most developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at large, will ultimately depend not only on considerations of procedural fairness, but also on the congruence between a society’s values and its institutions. We study social values, institutions and decisions in three countries (France, Germany and the United Kingdom) in order to assess such congruence and formulate expectations on its effects.

Type
Articles
Copyright
© Cambridge University Press 2014 

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