Taking Health Care Seriously: The Role Of For-Profit In The Just Allocation Of Health Care Resources
Western health care systems are currently facing serious scarcity and access issues. These problems can only be tackled by first unpacking the rationales that underlie legislators' enactments of laws producing suboptimal outcomes for the distribution of health care resources. Thus, this dissertation proposes to analyze the motives behind the drafting of health care allocation laws in the United States and in the United Kingdom. In particular, it examines the influence of justice principles and the role played by the for-profit sector in the development of distributive norms in these jurisdictions. I begin my analysis by arguing that the special nature of health care mandates that its resources be justly allocated. To form a theoretical framework for the analysis of health care financing and provision laws, I flesh out four philosophical archetypes that elaborate this assumption. The libertarian, egalitarian, utilitarian, and communitarian conceptions of justice collectively form the reading grid that I apply to analyze discourses in key legislative preparatory work and debates to appraise whether justice principles have participated or guided the legislative process. Using the same discourse-analysis method, I also assess the role played by for-profit actors in the negotiations and drafting of these laws and conclude that the for-profit sector plays a crucial role in their elaboration and has, over time, set a path of dependence affecting health care policy-making in both of these welfare states. The goal of this dissertation is not to provide concrete prescriptions for health care lawmaking, nor is it to assess how one unique conception of justice should supersede others for the allocation of health care resources. Rather, it maps out the presence (or the absence) of multiple conceptions of justice and their influence on the for-profit sector during the creation of health care reforms. This project calls attention to a dimension of justice in health care law through a philosophical analysis of the legislative process and hopes to provide a stepping-stone for future research to determine which conception of justice leads to the most optimal allocation processes and will finally tackle scarcity and access issues affecting western health care systems.
Health Care; Distribution; For-Profit
Ndulo, Muna B.
Hockett, Robert C.; Thomas, Chantal
Doctor of Science of Law
dissertation or thesis