Perhaps I should have been more explicit when pointing out that when
comparing "efficiency" with "equity" I was, as I said, taking the
efficiency objective to mean "a desire to improve overall population
health as much as possible" and the equity objective to mean "the
reduction of inequalities in people's lifetime experience of
health" It is certainly possible to think of trade-offs between
these objectives, which will be relevant to judging the effectiveness of
particular activities, even if they purport only to be directed at one
of the objectives. We might then say that the cost, in terms of
worsening health inequalities, in going single-mindedly for improving
the overall health of the entire population, is "too high".
Conversely, in some other situation, we may say that the cost, in terms
of sacrifices in overall population health, of going single-mindedly for
reducing health inequalities, is too high. And this is quite
independent of whether the particular policies we are looking at are
"technically efficient" or not. Technically inefficient activities
simply reduce how much you can achieve from a given budget.
Alan Williams
Mike Hughes wrote:
>
> I don't see that that you can trade-off equity for efficiency as Alan
> suggests. In respect of the distribution of healthcare resources I would
> have thought that one of the few reliable measures of effectiveness, and
> thus of efficiency, was equitable distribution according to need. Thus the
> answer is yes it can be both. In fact it also means that health care
> resources can't be inequitable and efficient. It does not necessarily
> follow, however, that that all equitable services are efficient.
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