Advertisement

Limited Resources, Priorities, and Corruption

  • Matjaž Zwitter
Chapter

Abstract

In this chapter, we discuss the situation in countries with a national healthcare system and do not cover countries with private healthcare insurance or those where services are paid out of pocket. Very few countries can meet all the costs of modern medicine for all their citizens. The three consequences of the gap between the available resources and the costs of modern medicine are limited access to costly medical interventions, waiting times for diagnostic and therapeutic interventions, and list of priorities. From the ethical standpoint, it is essential that all three of these issues are openly discussed and agreed within a wide circle including medical professionals and representatives of the lay community. In case of lack of democratic agreement and of clear rules, access to medical care may depend on the social and/or economic position of an individual. In a society based on solidarity, such a situation is contrary to the ethical principle of justice and may be considered to be a form of corruption.

Keywords

Solidarity-based healthcare Limited resources Waiting periods Probability-based medicine Dr. Jerzy Einhorn Priorities Corruption 

Reference

  1. 1.
    Calltorp J. Priority setting in health policy in Sweden and a comparison with Norway. Health Policy. 1999;50:1–22.CrossRefGoogle Scholar

Suggested Reading

  1. Ciapponi A, Lewin S, Herrera CA, Opiyo N, Pantoja T, Paulsen E, et al. Delivery arrangements for health systems in low-income countries: an overview of systematic reviews. Cochrane Database Syst Rev. 2017;9:CD011083.  https://doi.org/10.1002/14651858.CD011083.pub2.CrossRefPubMedGoogle Scholar
  2. Cromwell I, Peacock SJ, Mitton C. ‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature. BMC Health Serv Res. 2015;15:164.  https://doi.org/10.1186/s12913-015-0814-3.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Fischer T, Langanke M. Individualized medicine: ethical, economical and historical perspectives. Berlin: Springer; 2015. ISBN-13: 978-3319346984.CrossRefGoogle Scholar
  4. Gaitonde R, Oxman AD, Okebukola PO, Rada G. Interventions to reduce corruption in the health sector. Cochrane Database Syst Rev. 2016;8:CD008856.  https://doi.org/10.1002/14651858.CD008856.pub2.CrossRefGoogle Scholar
  5. Goldberg DS. Public health ethics and the social determinants of health, Springer Briefs in Public Health. Berlin: Springer; 2017. ISBN: 978-3-319-51347-8.CrossRefGoogle Scholar
  6. Gu Y, Lancsar E, Ghijben P, Butler JR, Donaldson C. Attributes and weights in health care priority setting: a systematic review of what counts and to what extent. Soc Sci Med. 2015;146:41–52.  https://doi.org/10.1016/j.socscimed.2015.10.005.CrossRefPubMedGoogle Scholar
  7. Jamison DT, Alwan A, Mock CN, Nugent R, Watkins D, Adeyi O, et al. Universal health coverage and intersectoral action for health: key messages from disease control priorities, 3rd edition. Lancet. 2018;391:1108–20.  https://doi.org/10.1016/S0140-6736(17)32906-9.CrossRefPubMedGoogle Scholar
  8. Kagawa-Singer M, Dadia AV, Yu MC, Surbone A. Cancer, culture, and health disparities: time to chart a new course? CA Cancer J Clin. 2010;60:12–39.  https://doi.org/10.3322/caac.20051.CrossRefPubMedGoogle Scholar
  9. Kakuk P, editor. Bioethics and biopolitics: theories, applications and connections, Advancing Global Bioethics. Berlin: Springer; 2017. ISBN: 978-3-319-66249-7.Google Scholar
  10. Kantarjian H, Rajkumar SV. Why are cancer drugs so expensive in the United States, and what are the solutions? Mayo Clin Proc. 2015;90:500–4.  https://doi.org/10.1016/j.mayocp.2015.01.014.CrossRefPubMedGoogle Scholar
  11. Knaul F, Horton S, Yerramilli P, Gelband H, Atun R. Financing cancer care in low-resource settings. In: Gelband H, Jha P, Sankaranarayanan R, Horton S, editors. Cancer: disease control priorities, vol. Vol. 3. 3rd ed. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; 2015.Google Scholar
  12. Moses H 3rd, Matheson DH, Dorsey ER, George BP, Sadoff D, Yoshimura S. The anatomy of health care in the United States. JAMA. 2013;310:1947–63.  https://doi.org/10.1001/jama.2013.281425.CrossRefPubMedGoogle Scholar
  13. Nass SJ, Madhavan G, Augustine NR, editors. Making medicines affordable: a national imperative. Washington, DC: National Academies Press; 2017.Google Scholar
  14. Patel V, Parikh R, Nandraj S, Balasubramaniam P, Narayan K, Paul VK, Kumar AK, Chatterjee M, Reddy KS. Assuring health coverage for all in India. Lancet. 2015;386:2422–35.  https://doi.org/10.1016/S0140-6736(15)00955-1.CrossRefPubMedGoogle Scholar
  15. Prainsack B, Buyx A. Solidarity in biomedicine and beyond. Cambridge: Cambridge University Press; 2017. ISBN-13: 978-1107074248.CrossRefGoogle Scholar
  16. ten Have H. Vulnerability: challenging bioethics. Abingdon: Routledge; 2016. ISBN-13: 978-1138652675.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Matjaž Zwitter
    • 1
    • 2
  1. 1.Faculty of MedicineUniversity of MariborMariborSlovenia
  2. 2.Institute of OncologyLjubljanaSlovenia

Personalised recommendations