Dear SDOH Colleagues,

Obviously issues of Public Health, Ethics, and Equity with their
interaction have become more and more important. However
they should be regarded in connection with the issues of Efficiency.

The society is at a crossroad and a choice must be made -
       * either will pay more and more for medical services
            (if can afford this + how sustainable is this)
       * either will pay attention also to other factors influencing health.
            (if wants to increase efficiency in relation to health)

The logical answer seems clear since main concern of members of the society
is the health status of these members, and medical services although
being very important are only ONE of the tools to provide this health
status.

With limited resources when choices are made and people are
rational in their decisions there are two possible approaches in
economics for resource allocation:
    - Kaldor-Hicks criterion ( we can get either Equity OR Efficiency, but
NOT both)
or
    - Equity and Efficiency ARE interdependent

My paper "What should be the Theoretical Foundation of Public Health"
(presented on The 3rd International Conference on Urban Health,
 October 20-22, 2004,  Boston ) is about the interdependence of
Public Health, Ethics, Equity and Efficiency.

 Based on declared by society Ethics (that all people are of equal value)
my paper explains :
 WHY preferences of those who finance health care services collectively
 should be considered;
 WHY application of Kaldor-Hicks criterion as tool for resource allocation
  in relation to health is misleading and deceiving;
 WHY Efficiency in relation to Health can not be separated from Equity;
 WHY redistribution of services is more efficient than redistribution of
  income;
 WHY are SDOH important in order to achieve allocative efficiency in
  relation to health;
 WHAT should be the NORMATIVE (economics) foundation for achieving
  health/utility maximization;

As mentioned by Robert Beaglehole there are "very small number
of publications on the ethics of public health and health inequalities"
and I think that the paper is a contribution to this important discussion.

A wide discussion on these issues will be a step towards sustainable and
prosperous for everyone society.

I'm sure that all involved in Public Health will benefit of it.

Please send an e-mail to [log in to unmask] , if you want to get the
paper.

 Jordan Panayotov, MBA, MPH
Director
Independent Centre for Analysis and Research of Economies
Melbourne, Australia

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