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Need, equality and social justice

  • Tony J Culyer
  • Alan Wagstaff

It is frequently claimed that social justice requires that some goods – medical care is a frequently cited example – be distributed according to “need”. The most common justification for adoption of this principle is the cause of inequality: the principles of “distribution according to need” and “equality” are seen as interrelated. In this paper we propose a definition of need and explore the distributional implications of allocating resources according to need. We dispute the claim that the principles of equality and “distribution according to need” are in any way linked and argue that the latter is unlikely in general to result in the attainment of equality and may actually increase inequality.

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File URL: http://www.york.ac.uk/media/che/documents/papers/discussionpapers/CHE%20Discussion%20Paper%2090.pdf
File Function: First version, 1991
Download Restriction: no

Paper provided by Centre for Health Economics, University of York in its series Working Papers with number 090chedp.

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Length: 20 pages
Date of creation: Oct 1991
Date of revision:
Handle: RePEc:chy:respap:90chedp
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  1. Sen, Amartya K, 1979. "Personal Utilities and Public Judgements: Or What's Wrong with Welfare Economics?," Economic Journal, Royal Economic Society, vol. 89(355), pages 537-58, September.
  2. Le Grand, Julian, 1978. "The Distribution of Public Expenditure: The Case of Health Care," Economica, London School of Economics and Political Science, vol. 45(178), pages 125-42, May.
  3. Wagstaff, Adam, 1991. "QALYs and the equity-efficiency trade-off," Journal of Health Economics, Elsevier, vol. 10(1), pages 21-41, May.
  4. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
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