Alex argued that the equity/equality discussion diverts attention from the
"need to advocate aggressively for whatever equity and equality we can
pragmatically aspire to achieve".
Although I agree we need to advocate (probably aggressively and certainly
pragmatically) for equity AND equality, I don't agree that this
equity/equality discussion is diversionary. John argues this sort of
discussion is crucial in helping us move our agenda forward and I think that
is right.
However I suspect Alex is also right when he argues in his most recent e
that "inequalogists divide up into two types - those for whom equity is a
value and those for whom it is an interesting subject for research and / or
policy".
As a practicising health "inequalogist" rather than academic one, and one
for
whom my day to day job happily reflects my personal ethical and political
values, I can't agree that the debates about definitions and strategies are
well beyond their sell-by dates. Clarity of thought and vision are critical
to the day-to-day business of pragmatic and effective advocacy for equity
and
equality. In particular when making the point that reducing or eliminating
health inequality (that is inequity) is a mammoth but ethically valuable and
at least theoretically an achievable task. Thus countering both the right
wing inspired fatalist argument that health inequities reflect inevitable
inequalities in any society, and the left wing fatalist argument that health
inequities reflect inevitable inequalities in feudal, capitalist or
post-capitalist societies.
In respect of health inequalities this latter position seems to me to be not
disimilar to Trotsky's idea of a "transitional demand". Thus incorrigible
bourgeois liberals and whigs like myself are pursuaded to sign up for health
equality, in the expectation that we will turn to revolution when
thwarted. So be it, but I am not likely to be persuaded to revolution by an
a priori connection between economic inequalities and health inequalities.
Seasons greetings
Mike
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