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Health Policy in a New Key: Setting Democratic Priorities
Author(s) -
Jennings Bruce
Publication year - 1993
Publication title -
journal of social issues
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.618
H-Index - 122
eISSN - 1540-4560
pISSN - 0022-4537
DOI - 10.1111/j.1540-4560.1993.tb00926.x
Subject(s) - grassroots , democracy , legitimacy , scope (computer science) , value (mathematics) , process (computing) , health policy , political science , politics , health care , public administration , public relations , public economics , economics , computer science , law , machine learning , programming language , operating system
Health policy in the United States is entering an era in which explicitly value‐based allocation decisions require direct attention. Policies concerning access to care, financing, and utilization management will necessarily have redistributive effects. For these policies to command social legitimacy and political support, some consensus will have to emerge around the values and ideals justifying these policies. This article addresses the problems of conceptual clarification and democratic process raised by the prospect of an explicitly value‐based allocation policy. It offers a conceptual matrix distinguishing the scope of the issue of allocation in health care. Drawing on the activities of community health decisions projects in several states, it also offers suggestions about building a participatory and educational process at the grassroots level that might lead to a democratic consensus suitable for guiding policy choices.