DETERMINING EQUITABLE AMOUNTS OF CARE
While the health capability paradigm does not guarantee equal outcomes, it requires society to enable conditions in proportion to individuals’ and groups’ health needs.
It follows the principle of proportional distribution, using equitable access to reduce the gaps between health achievement and health potential. Individuals deserve the resources they need to reach a necessary level of health functioning, and unequal amounts of care for patients with different conditions may be required.
There are some objections to this high-quality standard for equitable access:
i) It gives priority to a stepwise approach to achieve equity as efficiently as possible
ii) Universal care might be politically or administratively unfeasible
iii) Those who believe that some people deserve higher quality care than others
However, it is important to recognize that the long-term costs of failing to provide high quality evidence-based health care might very well exceed the initial costs of providing this level of care for everyone. Additionally, we must educate the public and elected representatives of the equity and efficiency of this approach to ensure widespread commitment to these standards.
The health capability paradigm goes beyond a “decent minimum” and notions of “equal quality” and “equal opportunity.” Rather, the goal is high quality. High quality medically necessary and medically appropriate care should be possible for everyone. While it requires universal treatment for all people as having equal moral worth, the paradigm accounts for individuals’ shortfalls in capabilities for health functioning and health agency and accommodates needs accordingly.