Dear All,


Persistent and growing health inequalities are a clear evidence for serious 
problems in public health. After all, this situation is exactly the opposite 
of declared goal for improving health and quality of life among whole 
populations and achieving highest attainable health for all.



Passionate appeals for more equity in the distribution are easily dismissed 
from neoliberals on efficiency ground. This happens, because they have 
theoretical platform - Kaldor-Hicks criterion for efficiency. Based on it, 
they say: "We can have either equity or efficiency, but not both. Since 
resources are limited, efficiency is paramount. Therefore, although 
regrettable, we have to sacrifice equity."



Risking to infuriate all of you, I have to say: Yes, they are right, BUT for 
a society, where: 1) people are of different value, i.e. some individuals 
are valued much more than others; 2) people have different rights, i.e. some 
individuals have more rights than others; and 3) there is no public 
financing for health, i.e. everyone pays everything only with his/her own 
money (no subsidies at all).



Since all tree points of the above mentioned conditions are not valid in the 
civilized, contemporary world, Kaldor-Hicks criterion for efficiency simply 
is not applicable in relation to health.



Unfortunately, so far no one from "the good guys" was able to back up the 
claims for more equity in relation to health on a normative (in economics) - 
what ought to be - ground.



Here I offer you a model, i.e. a theoretical foundation, explaining why in a 
society, where: 1) all people are of equal value; 2) every individual has 
the right to highest attainable health; and 3) most (60%-90%) of the funds 
for health are public, EQUITY IS A PREMISE FOR EFFICIENCY.



I realize that for many of you this paper might be a little bit too 
challenging, or "too technical", as one of your colleagues from a Nordic 
country mentioned to me. I have tried not to use too specialized language 
from economics and to present the information in a simple and logical way, 
thus make it understandable for anyone. Those, who comprehend it, will 
discover a mighty power to get you out of the "Phantom Zone".


Here it is: Panayotov Matrix.pdf

 http://docs.google.com/fileview?id=F.aa4921a2-e7a3-43dc-a781-66979dabf4a4

Should you decide to ask how it applies in a specific case, please contact 
us at  http://www.icare.biz/contact_us.html

Or, if you think you can handle it on your own, ask for the appropriate 
permission at  [log in to unmask]

All the best,

Jordan

---
Jordan Panayotov MEc MPH (Health Economics)
Director
Independent Centre for Analysis & Research of Economies
Melbourne, Australia
www.icare.biz
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