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Reducing inequalities in what? The Norwegian priority setting commissions' views on prospective shortfall versus lifetime shortfall.
Professor Jan Abel Olsen will present the first of two HERU Seminars in February. He is a Professor in Health Economics at the Department of Community Medicine, University of Tromsø in Norway; Adjunct Professor in the Centre for Health Economics, Monash University, Australia; and a part time researcher in The Norwegian Knowledge Center for the Health Services (NOKC), Oslo.
Professor Olsen's research interests include: measurement and valuation of health outcomes; efficiency vs equality; primary care financing; socio-economic determinants of health; global health. He was a member of the government appointed commission recommending new priority setting guidelines in Norway and has published extensively in the leading health economics journals.
The title of the seminar is: Reducing inequalities in what? The Norwegian priority setting commissions’ views on prospective shortfall vs lifetime shortfall.
Policy objectives in most publicly funded national health services relate to efficiency as well as health maximization, and equity in the distribution of health gains. The more a health care programme contributes to the reduction in inequality the more valuable it is, and hence the more society is willing to pay for the programme.
The critical question then is which type of health inequalities are to be reduced, i.e. equality of what? Different countries have been influenced by different equity criteria. This paper will outline four criteria: (i) prognosis (e.g. the ‘end-of-life’ argument in the UK), (ii) relative shortfall (proposed in the Netherlands), (iii) absolute (prospective) shortfall, and (iv) lifetime (total) shortfall. The last two criteria have recently been on the health policy agenda in Norway. They differ on whether past health losses are considered priority relevant.
An analytical framework is presented to compare and illustrate the key differences across the four criteria. This is followed by a normative discussion, emphasizing the discourse on prospective versus lifetime shortfall. It is shown that a lifetime approach to shortfall is less ‘ageist’ and more favourable to the chronically ill than the prospective approach inherent in the absolute shortfall criterion.
HERU External Seminars Programme
- Venue
- Room 3:052, Polwarth Building, Foresterhill, University of Aberdeen..