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Book and Media Reviews
September 22/29, 2010

Health and Social Justice

JAMA. 2010;304(12):1386-1387. doi:10.1001/jama.2010.1381

The thesis of Health and Social Justice is that a new way of discussing health policy and health reform in general (and health care in particular) is needed. The author offers such a new paradigm.

The argument begins by summarizing how health reform and health policy discussions and debates have been flawed because they have been based on 5 unworkable ways of considering health at its core: A utilitarian approach implies that it is easy to determine what works; in the area of health, that is not always the case. A communitarian approach implies that there is one set of community values and that this set is universal across all communities; that assumption is not uniformly valid, especially in terms of health and health care. An egalitarian approach implies that certain goods should be divided equally; sometimes, different individuals or groups of individuals require more of a health-promoting commodity and sometimes less. A libertarian approach values individual liberties and the free market; the free market has not, heretofore, brought a solution to the nation's health woes. A democratic approach includes as much public input as possible when deciding what health priorities should be and who should receive them; majority rule does not always equate with the most moral stance, especially in health care.

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