Equity in the context of diversity of culture and diversity of economic systems

doi:10.1017/CBO9780511544460.005

4 - Equity in the context of diversity of culture and diversity of economic systems

Published online by Cambridge University Press: 22 August 2009

Gavin Mooney

Edited by

Di McIntyre and

Gavin Mooney

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Gavin Mooney: Affiliation:
Director of Social and Public Health Economics Research Group, Curtin University, Bentley Campus Room 436 Bldg 400 Perth, WA 6845, Australia
Di McIntyre: Affiliation:
University of Cape Town
Gavin Mooney: Affiliation:
Curtin University of Technology, Perth

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Summary

This chapter argues that the construct of health and the nature of health care systems and, in turn, of equity in health and health care are in significant part cultural phenomena. This is in distinction to the universalism with respect to these issues that is usually the case in health economics assessments of both health and equity.

Acknowledgement that these are cultural phenomena, and that the literature on the social determinants of health indicates that being comfortable in one's culture is good for our health, means that globally there is a need to protect the diversity of societies and of cultures. Further, the nature of a society and its culture are heavily influenced by the economic system in which they exist. This chapter, therefore, argues that an important way of protecting the diversity of societies and of cultures is through the preservation of the diversity of economic systems.

Such preservation of diversity can be undermined by the impact of neo-liberalism's individualism and its adverse effects on the development of a sense of community. This can result in reducing social capital, which in turn can adversely affect population health and its distribution.

In the light of these observations, a new paradigm for the economics of health equity is proposed, based not on the values of individuals qua individuals, but more on the values of communities. Adopting a communitarian stance provides a new and potentially more useful approach to the economic analysis of equity in health and health care.

Type: Chapter
Information: The Economics of Health Equity , pp. 59 - 76

DOI: https://doi.org/10.1017/CBO9780511544460.005 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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References

Adams, V. (2004) Equity of the ineffable: cultural and political constraints on ethnomedicine as a health problem in contemporary Tibet. In Anand, S.Peter, F. and Sen, A., eds, Public Health, Ethics and Equity. Oxford: Oxford University Press. pp. 283–305.Google Scholar

Avineri, S. and De-Shalit, A. (1992) Introduction. In Avineri, S. and De-Shalit, A., eds, Communitarianism and Individualism. Oxford: Oxford University Press. pp. 1–11.Google Scholar

Broome, J. (1991) Weighing Goods. Oxford: Basil Blackwell.Google Scholar

Chomsky, A. (2000) The threat of a good example: health and revolution in Cuba. In Kim, J. Y., Millen, J. V., Irwin, A. and Gersham, J., eds, Dying for Growth: Global Inequality and the Health of the Poor. Monroe, ME: Common Courage Press. pp. 331–357.Google Scholar

Chomsky, N. (2003) Hegemony or Survival. New York: Henry Holt.Google Scholar

Commonwealth Grants Commission (2001) Report on Indigenous Funding. Canberra: Commonwealth of Australia.

Cooper, R. S.Kennelly, J. F. and Ordunez-Garcia, P. (2006) Health in Cuba. International Journal of Epidemiology. 35: 817–24.CrossRef Google Scholar PubMed

Culyer, A. J. (1990) Demand-Side Socialism and Health Care. Keynote paper presented at the Second World Congress on Health Economics. Zurich: University of Zurich.Google Scholar

Culyer, A. J. (1991) Equity in Health Care Policy. Paper prepared for the Ontario Premier's Council on Health, Well-being and Social Justice. Toronto: University of Toronto.Google Scholar

DHSS (1976) The RAWP Report. Resource Allocation Working Party. Sharing Resources for Health in England. London: HMSO.

Dowbar, L. (1997) Preface. In Freire, P.Pedagogy of the Heart. New York: Continuum Publishing.Google Scholar

Drèze, J. and Sen, A. (1989) Hunger and Public Action. Oxford: Oxford University Press.Google Scholar

Freire, P. (1996) Pedagogy of the Oppressed. New York: Continuum Publishing.Google Scholar

Fukuyama, F. (1992) The End of History. New York: Simon and Schuster.Google Scholar

Harris, R., Tobias, M., Jeffreys, M.et al. (2006) Racism and health: the relationship between experience of racial discrimination and health in New Zealand. Social Science and Medicine. 63(6): 1428–1441.CrossRef Google Scholar PubMed

Henry, B., Houston, S. and Mooney, G. (2004) Institutional racism in Australian health care: a plea for decency. Medical Journal of Australia 180(10): 517–520.Google Scholar PubMed

Houston, S. (2004) Aboriginal Health Policy: the Past, the Present, the Future. Ph.D. thesis. Perth: Curtin University.Google Scholar

Jensen, U. J. and Mooney, G. (1990) Changing values: autonomy and paternalism in medicine and health care. In Jensen, U. J. and Mooney, G., eds, Changing Values in Medical and Health Care Decision Making. New York: John Wiley. pp. 1–15.Google Scholar

Millen, J. V., Irwin, A. and Kim, J. Y. (2000) Introduction: What is growing? Who is dying? In Kim, J. M., Millen, J. V., Irwin, A. and Gersham, J., eds, Dying for Growth. Monroe, Maine: Common Courage Press.Google Scholar

Mooney, G. (1998) Communitarian claims as an ethical basis for allocating health care resources. Social Science and Medicine, 47(9): 1171–1180.CrossRef Google Scholar PubMed

Mooney, G. (2000) Vertical equity in health care resource allocation. Health Care Analysis. 8(3): 203–215.CrossRef Google Scholar PubMed

Mooney, G. (2001) Communitarianism and health economics. In Davis, J., ed., The Social Economics of Health Care. London: Routledge. pp. 24–42.CrossRef Google Scholar

Mooney, G. and Blackwell, S. (2004) Whose health service is it anyway?Medical Journal of Australia. 180: 76–78.Google Scholar PubMed

Mooney, G. and Russell, E. (2003) Equity in health care: the need for a new economics paradigm. In Scott, A., Maynard, A. and Elliott, R., eds, Advances in Health Economics. Chichester: Wiley.Google Scholar

Muller, J. Z. (2003) The Mind and the Market, Capitalism in Western Thought. New York: Anchor Books.Google Scholar

Navarro, V. (2000) Are pro-welfare state and full-employment policies possible in the era of globalization?International Journal of Health Services. 30(2): 231–251.CrossRef Google Scholar PubMed

Rosenberg, T. (2002) Globalization; the free trade fix. New York Times. (August 18): 28.

Sen, A. (1992) Inequality Re-examined. Oxford: Clarendon Press.Google Scholar

Sen, A. (2001) Economic progress and health. In Leon, D. and Walt, G., eds, Poverty Inequality and Health. Oxford: Oxford University Press. pp. 333–345.Google Scholar

Shiva, V. (1998) Monocultures of the Mind. www.resartis.org/index.php?id=74.

UNDP (1999) Human Development Report. New York: OUP.

WHO (2000) World Health Report 2000. Geneva: WHO.